ABSTRACT
Objective To investigate the clinical value of cardiopulmonary resuscitation (CPR) with abdominal lifting and compression on patients with breathing and cardiac arrest induced by severe chest trauma.Methods Sixty-six breathing and cardiac arrest patients induced by severe chest trauma admitted to the General Hospital of Jingyuan Coal Industry Group Company from October 2011 to October 2016 were enrolled,and they were divided into abdominal lifting and compression group (n =32) and unarmed abdominal compression group (n =34) by random number table.The patients in both two groups were given the airway open,respiration support,defibrillation treatment,venous access establishment,vasoactive drugs application and other conventional treatments.On the basis of the routine treatment,the patients in abdominal lifting and compression group were given application of abdominal lifting and compression device with 100 times/min frequency and continuously alternating press down to lift the abdomen,the amplitude of pressing and pulling were 3-5 cm below or above the original level of the abdomen.Those in unarmed abdominal compression group were given abdominal CPR pressing method by hand,the frequency of pressing and depth of subsidence was the same as abdominal lifting and compression group.Heart rate (HR) and arterial blood gas at 30 minutes after CPR as well as the success rate of resuscitation were compared between the two groups.The changes in HR,mean arterial pressure (MAP) and pulse oxygen saturation (SpO2) before and 30 minutes and 60 minutes after CPR were dynamically observed in patients with restoration of spontaneous circulation (ROSC) after abdominal lifting and compression CPR treatment.Results Compared with the unarmed abdominal compression group,HR (bmp:136.13±6.14 vs.148.45±5.16) and arterial partial pressure of carbon dioxide [PaCO2 (mmHg,1 mmHg =0.133 kPa):48.51 ±2.60 vs.62.51 ±2.50] at 30 minutes after CPR in abdominal lifting and compression group were significantly lowered,and arterial partial pressure of oxygen (PaO2) was significantly increased (mmHg:88.07±3.92 vs.74.12±2.12,all P ＜ 0.05).Four patients with ROSC were found in abdominal lifting and compression group,and 2 in unarmed abdominal compression group.The success rate of resuscitation in abdominal lifting and compression group was significantly higher than that of unarmed abdominal compression group (12.50％ vs.5.82％,P ＜ 0.05).In 4 patients with ROSC after abdominal lifting and compression CPR showed a downward trend in HR and an upward trend in MAP and SpO2 with CPR time prolongation.Conclusions The effect of abdominal lifting and compression CPR is better than that of unarmed abdominal compression CPR,which is of great value for the life saving of patients with breathing and cardiac arrest induced bv severe chest trauma.
ABSTRACT
Objective To study the effectiveness and safety of abdominal lifting and compression method in patients sufferred from cardiac arrest (CA).Methods According to the inclusion and exclusion criteria,72 patients from Hainan People's Hospital and Zhengzhou People's Hospital were enrolled for study of abdominal lifting and compression (ALC) method from January 2014 to June 2015.The markers of respiratory and circulatory performance of all patients were recorded,and re-collected after CPR with ALC.In addition,the data of demographics and clinical signs of patients were collected.The rates of restoration of spontaneous circulation (ROSC) and successful resuscitation were calculated.Differential analysis of singlegroup design univariate quantitative and qualitative data was carried out.Results A total of 72 patients were included finally.The ROSC rate was 15.3％ (11/72) after using ALC equipment,and there was no statistically significant difference in rate of ROSC (P =0.566) between ALC and pre-test (13.0％).However,compared with NT group resuscitated without using ALC method or with using chest compression method,the rate of ROSC was significantly improved in the ALC group (15.3％ vs.O.1％,P ＜ 0.01).Conclusions Abdominal lifting and compression CPR equipment is stable,portable and safe in practice.Abdominal lifting and compression CPR method has its prominent role in saving patients from respiratory and cardiac arrest,and it is sufficient to overcome the disadvantages of conventional CPR method.
ABSTRACT
Objective To investigate the clinical application of rhythmic abdominal lifting and compression cardiopulmonary resuscitation (ALC-CPR) in cardiac arrest (CA) patients with conventional cardiopulmonary resuscitation (CPR) contraindication (chest rib fracture, chest trauma, etc.).Methods The clinical data of patients with CA in emergency department of Hefei Second People's Hospital from June 2015 to December 2016 were analyzed retrospectively, and the patients with weights 40-150 kg and CA≤20 minutes, and resuscitated with ALC-CPR were selected. The vital signs and blood gas analysis indexes of patients before resuscitation and 30 minutes after return of spontaneous circulation (ROSC, after successful resuscitation) were recorded.Results A total of 19 patients with CA were treated with CPR-LW1000 type ALC-CPR apparatus for resuscitation, and with 12 males, 7 females; the age ranged from 43 to 87 years, and the average age was (70.32±13.49) years; there were 4 cases of heart disease, and 15 cases of non-heart disease. Compared with before resuscitation, the heart rate [HR (bpm): 115.05±21.70 vs. 0], mean arterial pressure [MAP (mmHg, 1 mmHg = 0.133 kPa): 66.05±11.69 vs. 0], pulse oxygen saturation (SpO2: 0.928±0.057 vs. 0.417±0.118), pH value (7.05±0.23 vs. 6.80±0.28), arterial oxygen partial pressure [PaO2 (mmHg): 65.42±19.11 vs. 42.42±10.78], HCO3- (mmol/L: 19.22±2.77 vs. 17.18±3.76) were significantly improved after successful resuscitation (allP 0.05).Conclusion Rhythmic ALC-CPR has obvious clinical value for CA patients with conventional CPR contraindication.