Predictors and Outcome of in-Hospital Cardiac Arrest Patients in Emergency Department Suez Canal University Hospitals

Background: In-hospital cardiac arrest (IHCA) is defined as cessation of cardiac activity, confirmed by the absence of signs of circulation, in a hospitalized patient who had a pulse at the time of admission. The purpose of the present study was to record the definitive predictors of IHCA, focusing on the relation between cause and outcome as well as the influence of location on survival. Subjects and Methods: This prospective observational study (cross sectional) was carried out in Emergency Department at Suez Canal University Hospital and included 223 patients experiencing IHCA at the Emergency Department (ED). Results: Our study showed return of spontanous circulation (ROSC) rate of 27.4%, which is lower than those reported in other studies from the region. In our study, we found that the overall mean duration for comprehensive cardiopulmonary resuscitation (CPR) was 21 min (SD ± 10).We found that Pulse, RR, BP, Witnessed and advanced life support (ALS) interventions at time of event were significant positive predictors to ROSC with patients while age, modified early warning score (MEWS), Interval between collapse to start CPR and CPR duration were negative predictors to cognitive impairment with diabetic patients. Conclusions: IHCA can be predicted using different variable related to patients vital data, laboratories, radiological investigations and patient demographic data which helps in predicting and modifying the outcome in limited situations.

Improving cardiopulmonary resuscitation (CPR) performance using an audio-visual feedback device for healthcare providers in an emergency department setting in Malaysia: a quasi-experimental study

@#Introduction: Cardiopulmonary Resuscitation (CPR) remains the primary mechanism of resuscitation for cardiac arrest victims. However, the quality of delivery of CPR varies widely in different settings, possibly affecting patient outcomes. This study is aimed to determine the efficacy of an audio-visual (AV) CPR feedback device in improving the quality of CPR delivered by healthcare providers. Methods: This pre-post, single-arm, quasi-experimental study randomly sampled 140 healthcare providers working in the Emergency Department of Hospital Ampang, Malaysia. Parameters of CPR quality, namely chest compression rate and depth were compared among participants when they performed CPR with and without an AV CPR feedback device. The efficacy of the AV CPR feedback device was assessed using the Chi-square test and Generalised Estimating Equations (GEE) models. Results: The use of an AV CPR feedback device increased the proportion of healthcare providers achieving recommended depth of chest compressions from 38.6% (95% Confidence Interval, 95%CI: 30.5, 47.2) to 85.0% (95%CI: 78.0, 90.5). A similar significant improvement from 39.3% (95%CI: 31.1, 47.9) to 86.4% (95%CI: 79.6, 91.6) in the recommended rate of chest compressions was also observed. Use of the AV CPR device significantly increased the likelihood of a CPR provider achieving recommended depth of chest compressions (Odds Ratio, OR=13.01; 95%CI: 7.12, 24.01) and rate of chest compressions (OR=13.00; 95%CI: 7.21, 23.44). Conclusion: The use of an AV CPR feedback device significantly improved the delivered rate and depth of chest compressions closer to American Heart Association (AHA) recommendations. Usage of such devices within real-life settings may help in improving the quality of CPR for patients receiving CPR

Application of new-type cardio-pulmonary resuscitation marking table in large scale group examination / 中华医学教育探索杂志

Objective To explore the application of new-type cardio-pulmonary resuscitation (CPR) marking table in CPR teaching and assessment of new students.Method The students were divided into five-year group and four-year group based on different cultivation durations;the five-year group received conventional teaching while the four-year group received targeted teachingfocusing on key points on that basis.The assessment of both groups applied this marking table to compare average score,failure rate,full mark rate and error rate of 13 operations in marking table between the two groups.With the help of SPSS 19.0 software,the results were analyzed by t-test and chi-square test.Result The four-year group was higher than five-year group in average score and full mark rate (t=3.118,P=0.002;x2=26.798,P=0.000),but it was lower than five-year group in failure rate (x2=14.159,P=0.000),the difference was statistically significant.The error rate of 9 operations in five-year group,including on-sitesafety assessment (x2=44.764,P=0.000),calling for help (x2=8.854,P=0.003),press part (x2=10.236,P=0.001),press depth (x2=140.775,P=0.000),press interruption＜10 s (x2=7.377,P=0.007),opening airway (x2=20.209,P=0.000),twice effective artificial respiration (x2=37.669,P=0.000),evaluation (x2=20.898,P=0.000) and humanistic care (x2=45.673,P=0.000),were higher than that in four-year group;the difference of error rate of 4 operations between two groups was not statistically significant,including recognizing sudden cardiac arrest (x2=3.316,P=0.069),press frequency (x2=0.234,P=0.629),full resilience (x2=0.18,P=0.671) and press point movement (x2=3.614,P=0.057).Conclusion The new-type CPR marking table objectively reflects students' operation,summarizes operation errors and gives feedback of guidance teaching,so it is applicable for mass assessment with convenient use and less teaching load.

Effect of mild hypothermia on the oxidative stress induced myocardial injury after cardiopulmonary resuscitation / 中华急诊医学杂志

Objective To observe the effects of mild hypothermia on the myocardial mitochondrial injury induced by oxidative stress after restoration of spontaneous circulation (ROSC) in rat of cardiac arrest model.Methods Eighteen male Wistar rats were randomly (raudom number) divided into normal temperature group and mild hypothermia group after ROSC.Ultrasound was used to measure the left ventricular ejection fraction (EF),shortening fraction (FS) and stroke volume (SV).The levels of glutathione (GSH),malondialdehyde (MDA) and adenosine triphosphate (ATP) in myocardium were detected.The ultramicroscopic structure of myocardial mitochondria was observed under transmission electron microscope at 4 h after ROSC.Results There were no significant differences in basic life support (BLS) time,dosage of epinephrine and number of defibrillation attempt between two groups (P ＞ 0.05).The concentrations of GSH and ATP in myocardium of rats in hypothermia group were significantly higher than those in normal temperature group,while the level of MDA was significantly lower in hypothermia group than that in normal temperature group.Echocardiographic findings showed that hypothermia could significantly improve the EF,FS and SV after ROSC.The hypothermia decreased the myocardial mitochondria injury rather than normothermia [mitochondrial injury score:(0.21-±0.04) vs.(0.42 ±0.08),P ＜ 0.05].Conclusions In this model,mild hypothermia can decrease myocardial oxidative stress injury,improving the cardiac function after ROSC.

Neuroprotective effect of intracarotid cold saline infusion following cardiopulmonary resuscitation in a hypothermic cardiac arrest canine model / 解放军医学杂志

Objective To evaluate the effect of intracarotid cold saline infusion (ICSI) on neurological outcomes in canines with cardiac arrest (CA) introduced by severe hypothermia.Methods Restoration of spontaneous circulation (ROSC) after hypothermic CA was induced in 10 Beagle dogs.These 10 dogs were randomly divided into 2 groups (5 each).Dogs in control group were rewarmed using warn water bath,and dogs in experimental group received the bath rewarming plus ICSI for 6 hours to maintain the brain temperature ＜36℃.In both groups,the Neurologic Disability Scores (NDS) were recorded at 24h after the ROSC,and their brains were removed for pathologic analysis using hematoxylin and eosin stain.The brain water content and sl00β of serum level were also measured.Results The water content (79.43％ ± 0.72％ vs.80.79％ ± 1.06％,P＜0.05) and serum level of s100β (119.83 ± 42.93pg/ml vs.329.82 ± 190.39pg/ml,P＜0.05) were significantly lower in experimental group than in the control group.Control group presented obvious pathological damage of the hippocampal pyramidal cells.There was no significant difference in NDS between the two groups.Conclusion ICSI could reduce the production of s100β and pathological brain damage in postarrest hypothermic canines.

Assessment Of Knowledge And Awareness Of Adult Basic Life Support Among Post Graduate Students Of Rama Dental College, Kanpur City, India.

Background: Accidents and cardiac arrest are mostly encountered life threatening emergencies, which can sometimes be prevented by adequate knowledge and proper practice regarding basic life support (BLS) and resuscitation. Therefore, the study aims at evaluating the knowledge and awareness of adult basic life support among postgraduate students of Rama Dental College, Kanpur. Methodology: A cross- sectional descriptive study was been conducted amongst the postgraduate students regarding BLS. Permission was obtained from the Institutional heads and the review board. A self- structured questionnaire in English which was administered was validated via pilot study. The questionnaire comprised of 13 close ended questions including demographic details as well as questions regarding knowledge and awareness on Basic Life Support. A single calibrated examiner administered the questionnaire. Statistical analysis was done by calculating percentage and frequency distribution. Results: 100 postgraduate students were chosen as study subjects. Out of those, 95 students submitted the duly filled questionnaires. Therefore, it was seen that only 37%-38% students had knowledge regarding the meaning of BLS, while only 11% postgraduate students were aware of the latest modification of the BLS. 30%-37% students gave the correct response for the question ‘first response when you see a person unresponsive on road’. 56% students had knowledge regarding the location for compression of chest. Conclusion: In the current study, we found that most of the postgraduate students did not have adequate knowledge regarding BLS.

Comparison between an Instructor-led Course and Training Using a Voice Advisory Manikin in Initial Cardiopulmonary Resuscitation Skill Acquisition

PURPOSE: Purpose: We compared the outcomes of training between the use of voice-advisory manikin (VAM) and instructor-led (IL) courses with respect to the acquisition of initial cardio-pulmonary resuscitation (CPR) skills, as defined by the 2010 resuscitation guidelines. METHODS: This study was a randomized, controlled, blinded, parallel-group trial. We recruited 82 first-year emergency medical technician students and randomly distributed them into two groups: the IL group (n=41) and the VAM group (n=37). In the IL group, participants were trained in “single-rescuer, adult CPR” in accordance with the American Heart Association's Basic Life Support course for healthcare providers. In the VAM group, all subjects received a 20-minute lesson about CPR. After the lesson, each student trained individually with the VAM for 1 hour, receiving real-time feedback. After the training, all subjects were evaluated as they performed basic CPR (30 compressions, 2 ventilations) for 4 minutes. RESULTS: The proportion of participants with a mean compression depth ≥50 mm was 34.1% in the IL group and 27.0% in the VAM group, and the proportion with a mean compression depth ≥40 mm had increased significantly in both groups compared with ≥50 mm (IL group, 82.9%; VAM group, 86.5%). However, no significant differences were detected between the two groups in this regard. The proportion of ventilations of the appropriate volume was relatively low in both groups (IL group, 26.4%; VAM group, 12.5%; p=0.396). CONCLUSION: Both methods the IL training using a practice-while-watching video and the VAM training facilitated initial CPR skill acquisition, especially in terms of correct chest compression.

Practice and enlightenment of cardio-pulmonary resuscitation emergency training / 中华医学教育探索杂志

Objective Based on the international standard cardio-pulmonary resuscitation curriculum, the aim of the study is to investigate the effectiveness and importance of the layered cardio-pulmonary resuscitation emergency training. Method A total of 219 trainee including clinical medical personnel , auxiliary medical personnel and medical staff with standardized training were enrolled . Training included watching course video, team practice and class discussion, and the theoretical score and operation marks before and after layered cardio-pulmonary resuscitation training were compared. Theoretical score were compared by paired T-test, and operation pass ratio was determined byχ2 analy-sis. Results The pre- and post-training theoretical score of medical staff with standardized training, auxiliary medical personnel, and clinical medical personnel were 66.60±7.82 vs. 88.60±6.37;61.60± 7.44 vs. 86.90±5.80;73.45±6.83 vs. 94.75±5.04 respectively. The pre- and post-training operation pass ratio of marks of medical staff with standardized training, auxiliary medical personnel, and clinical medical personnel were 31.1%/85.2%;32.0%/90.7%;59.0%/96.4% respectively. Conclusion There are differences in both the theory and operation results of medical personnel at different levels before and after the training of cardiopulmonary resuscitation. The more targeted and layered training is much effective in cardio-pulmonary resuscitation emergency training.

Therapeutic effects of Shenfu injection on post-resuscitation syndrome / 中华急诊医学杂志

Objective To evaluate the therapeutic effects of Shenfu injection (a Chinese herbal preparation of Aconitum and Ginseng) for the treatment of patients with post-resuscitation syndrome (PCAS) and to investigate its mechanism as well.Methods The data of 80 patients with restoration of spontaneous circulation (ROSC) after cardiac arrest were collected,and the patients were randomly divided into the experimental group and the control group.The patients in experimental group received Shenfu injection in addition to conventional treatment,and the patients in control group just had the conventional treatment.The cerebral performance classification (CPC) scores,Glasgow Coma Scales cores and sequential organ failure assessment (SOFA) scores before treatment and on the 3rd,7th,14th and 28th days after treatment in the patients of two groups were monitored and compared.The length of ventilation time,total expenses and mortality of the patients were calculated and compared between two groups.Results The data of 3 patients were excluded from those of total 80 patients,because the information of those patients was not complete.Finally,there were 37 cases in experimental group and 40 patients in control group.The CPC scores of smrvived cases in experimental group were lower than those in control group on the 3rd,7th,14th and 28th days after treatment (P ＜ 0.05).The Glasgow Coma Scale scores in experimental group were higher than those in control group on the 14th and 28th days after treatment (P ＜ 0.05).The SOFA scores in experimental group were lower than those in control group on the 3rd,7th and 14th days after treatment (P ＜ 0.05).There were no significant differences in length of ventilation time and total expenses between two groups on the 3rd,7th,14th and 28th days after treatment (P ＞ 0.05).The mortality of the experimental group was lower than that in control group at the 28 th day after treatment (P ＜ 0.05).Conclusions The Shenfu injection could improve the prognosis of patients with post cardiac arrest syndrome.

Nursery Teachers' Knowledge, Attitude and Performance Ability in CardioPulmonary Resuscitation

PURPOSE: This study was done to identify the level of knowledge, attitude and performance ability in CardioPulmonary Resuscitation (CPR) and provided data for the development of an education program to improve CPR performance ability of nursery teachers. METHODS: The participants were 220 nursery teachers working in daycare centers in A city located in G province. Data were collected during July, 2013. RESULTS: The mean scores were 45.88 of 100 for knowledge, 3.69 of 5 for attitude, 2.65 of 5 for performance ability. There were significant differences in knowledge and performance ability according to education experience. There were positive correlations between knowledge and performance ability, and between attitude and performance ability. Factors affecting CPR performance ability were knowledge (beta=.133), attitude (beta=.327), and education in CPR (beta=.343). These factors explained 29.4% of the variance in CPR performance ability. CONCLUSION: Results indicate that nursery teachers' knowledge, attitude and CPR performance ability were not sufficient enough to perform accurate CPR in an emergency. Therefore, to improve performance ability of nursery teachers to carry out CPR in a cardiac arrest emergency of a child, educational strategies that focus on increasing knowledge and attitude need to be developed.

Study of a Modified Two-person Cardiopulmonary Resuscitation Method to Provide Effective Ventilation: Analysis Based on a Rescuer's Training Proficiency

PURPOSE: The purpose of this study is to compare the modified two-person cardiopulmonary resuscitation method (MM) (the first resuscitator performs chest compressions and squeezes the bag of bag-valve-mask (BVM) during pauses of compression, and the second resuscitator uses two hands to provide an open airway) using the conventional two-person cardiopulmonary resuscitation method (CM). METHODS: This simulation study used a manikin and a cross-over execution design and included 102 participants. After practice of CM and MM, participants were randomly assigned a partner. Each pair of participants performed the 2-CPR for five cycles using both methods alternately at random. All data were recorded in a personal computer and analyzed. RESULTS: Data from 510 cycles each of the CM and MM were analyzed. The MM generated a higher mean tidal volume (TV) (791.2 ml versus 563.8 ml, P<0.001) and more frequent visible chest ventilation (92.1% versus 64.7%, P<0.001). For the inexpert resuscitator group (50; 49%), the MM generated more frequent visible chest ventilation (88.6% versus 34.0%, P<0.001) and ventilation with an adequate TV (43.6% versus 32.0%, P<0.001). No significant difference in compression rate, depth, hand position, and release, and minimal difference of hands off time (0.5s) were observed between the two methods. CONCLUSION: The CM could not easily provide sufficient visible chest rise and might be a poor ventilation option for inexpert BVM resuscitators. The MM can be useful as an alternative method and preferable to the CM for inexpert BVM resuscitators.

Studies on the partial pressure of end-tidal carbon dioxide and the coronary perfusion pressure during the cardiopulmonary resuscitation in dogs / 中国介入心脏病学杂志

Objective To study the changes in and correlations between the partial pressure of end-tidal carbon dioxide (PETCO2) and the coronary perfusion pressure during cardio-pulmonary resuscitation (CPR) based on the cardiac arrest dog models of ventricular fibrillation by electric shock. Methods 36 healthy dogs were evenly randomized into 3 groups including 4 minutes close-chest CPR(CCCPR) group, 4 minutes open-chest CPR(OCCPR) group, and 8 minutes OCCPR group. There were 12 dogs in each group, half male and half female. In the process of CPR, all parameters about PETCO2 and CPP were recorded. Results In the 4 minutes CCCPR group, the correlation coefficient between the CPP and the PETCO2 was 0.992 (P<0.05), which was in positive linear correlation. In the 4 minutes OCCPR group, the correlation coefficient between the CPP and the PETCO2 was 0.937 (P < 0.05), which also showed positive linear correlation. In the 8 minutes OCCPR group, the correlation coefficient between the CPP and the PETCO2 was 0.952 (P<0.05), and was also in positive linear correlation. The percentage of ROSC was 66.7(8/12) in the 4 minutes CCOPR group, 100%(12/12) in the 4 minutes OCCPR group and 58.3%(7/12) in the 8 minutes OCCPR group. There were statistical differences in CPP, PETCO2 between models with ROSC and without ROSC at 1, 2, 5, 10, 15 and 20 mins of CPR (all P<0.05). Conclusions This research shows that there is a close positive linear relationship between the coronary perfusion pressure and the PETCO2, and PETCO2 could be used to evaluate the prognosis of the CPR.

Parada cardiorrespiratória e enfermagem: o conhecimento acerca do suporte básico de vida / Cardiorespiratory arrest and nursing: the knowledge on basic life support / Parada cardiorrespiratoria y enfermería: el conocimiento acerca del soporte básico de vida

Estudo descritivo e transversal cujo objetivo foi avaliar o conhecimento teórico dos enfermeiros de um hospital do interior de Minas Gerais-Brasil acerca do suporte básico de vida utilizado no atendimento à parada cardiorrespiratória. A amostra foi constituída por 16 enfermeiros, para a coleta de dados utilizou-se instrumento construído com base nas recomendações da American Heart Association para ressuscitação cardiopulmonar. Os resultados mostraram lacunas no conhecimento acerca dos ritmos identificados na parada cardiorrespiratória, sequência de atendimento, número de ciclos compressão versus ventilação, abertura das vias aéreas, local de colocação das pás do desfibrilador, procedimento a ser realizado imediatamente após o choque, e cargas, em joules, recomendadas para a desfibrilação. Recomenda-se a reavaliação e capacitação contínua dos enfermeiros para adequado desempenho no atendimento em parada cardiorrespiratória, contribuindo para a sobrevida da população.

The objective of this descriptive and cross-sectional study was to assess the theoretical knowledge of the nurses in a hospital in the state of Minas Gerais regarding the basic life support used in attending cardiorespiratory arrest. The sample was constituted by 16 nurses, and an instrument constructed based on the recommendations of the American Heart Association for cardio-pulmonary resuscitation was used for data collection. The results showed gaps in the knowledge on the rhythms identified in cardio-respiratory arrest, the sequence of steps, number of cycles versus ventilation, opening of the airways, where to place the defibrillator electrode pads, the procedure to be undertaken immediately after the shock, and the loads, in joules, recommended for the defibrillation. The re-assessment and continuous training of the nurses is recommended, for their adequate performance in treating cardiorespiratory arrest, contributing to the population's survival.

Estudio descriptivo y transversal cuyo objetivo fue evaluar el conocimiento teórico de los enfermeros de un hospital del interior de Minas Gerais, Brasil, acerca del soporte básico de vida utilizado en el atendimiento a la parada cardiorrespiratoria. La muestra fue constituida por 16 enfermeros y, para obtener los datos, fue utilizado instrumento construido con base en las recomendaciones de American Heart Association para resucitación cardiopulmonar. Los resultados apuntan huecos en el conocimiento acerca de los ritmos identificados en la parada cardiorrespiratoria, secuencia de atendimiento, número de ciclos compresión versus ventilación, apertura de las vías aéreas, local de colocación del desfibrilador, procedimiento a ser realizado inmediatamente después de las descargas eléctricas, y cargas, en joules, recomendadas para la desfibrilación. Se sugiere nueva evaluación y capacitación continua de los enfermeros para adecuado desempeño en el atendimiento en parada cardiorrespiratoria, contribuyendo para la sobrevida de la población.

Research on the function of multimedia teaching in rural doctor CPR training / 中国医学装备

Objective: To explore the function of multimedia teaching in rural doctor CPR training, to discuss the training methods for how to improve the CPR training in rural doctors. Methods: The method uses the grouping research the method, supposes the experimental group and the control group according to the stochastic grouping principle, separately uses the multimedia union heart and lungs anabiosis computer teaching to 62 rural doctors to simulate the human teaching method or the traditional version book teaching method situation conducts the track investigation and study. Results: In the result 62 examples experiments the group and the control group the result has the highly remarkable difference in the theory knowledge test and the operation inspection, has statistics significance (x2=7.4, p<0.01). Conclusion:The conclusion multimedia union heart and lungs anabiosis computer teaching simulates the human teaching training to have the remarkable function in rural doctor in the CPR, should give to promote.

A survey on the implementation of the early goal-directed therapy after cardio-pulmonary resuscitation in Suzhou area / 中华急诊医学杂志

Objective To evaluate the implementation of the early goal-directed therapy after cardiopulmonary resuscitation in Suzhou area,in order to provide clinical data for standardized post resuscitation care.Methods This retrospective study included comatose survivors of CA,admitted into intensive care units (ICU) of 10 hospitals in Suzhou area between January 2009 and December 2010.the parameters,mean arterial pressure (MAP),peripheral oxygen saturation (SpO2),partial pressure of carbon dioxide (PaCO2),blood glucose (Glu) and body temperature (T),were collected for 48 h after CA.The percentage of parameters achieving recommended goals was compared.Results A total of 101 CA patients were enrolled in this study.Among the parameters of GDT,the percentage of achieving recommended goals for SpO2 and MAP was 90.1％ and 81.4％ ; the percentage of achieving recommended goals for Glu and PaCO2 was 55.4％ and 32.8％ ; however,mild therapeutic hypothermia (MTH) reached the lowest percentage,only 10％ ; there were significant differences in the percentage of achieving recommended goals for these parameters,P ＜0.01.Conclusions The quality of early goal-directed therapy in the CA patients should be improved,especially in the management of body temperature and partial pressure of carbon dioxide.

PALS Update 2010.

During the past decade, guidelines for cardiopulmonary resuscitation have focused on the importance of high quality CPR. The purpose is to temporarily maintain a circulation to vital organs until specialized treatment is available. In, essence, it has been a revolution in pediatric resuscitation in terms of “coming full circle” to the 1960s when basic CPR was first developed. A fifth component to the pediatric chain of survival has been added with emphasis on integrated post cardiac arrest care. With mounting scientific evidences, American Heart Association published new Pediatric Advanced life support 2010 guidelines in accordance with the established five yearly cycle of guideline changes.

Knowledge and Attitude Toward BLS and Provided CPR Education among Nurses at General Wards in Pusan / 기본간호학회지

PURPOSE: A survey was done on knowledge and attitude toward CPR and provision of CPR education to nurses on general wards. METHOD: A survey of 280 nurses on general wards in four university hospitals with 700 beds or more in the city of Pusan was done. The data were collected from September 10, to September 22, 2007. RESULTS: The mean score for knowledge of Basic Life Support was 12.71 (mean converted to 100: 63). About 76% of the nurses believed that they had a responsibility to perform CPR, but 53.3% of the nurses were not confident to perform CPR. About 94% of the nurses had received education on CPR but 32.3% of those took it 6 to 12 years ago. About 41% of the nurses spent 3-4 hours for the education and 73.2% of those took simulation education. CONCLUSION: Although most of the nurses had received CPR education, they were not knowledgeable or confident. Therefore, better CPR education programs including up-dated knowledge are needed. More reinforced education should be offered every six months or on a yearly basis in order to enhance lasting efficiency.

The intervention effects of edaravone on aquaporin-4 expression in the rat brain following cardiopulmonary resuscitation / 中华急诊医学杂志

Objective To investigate the relationship between aquaporin-4 (AQP4) expression level inbrain and dynamic change of brain edema in rats after cardiopulmonary resuscitation (CPR), and to evaluate the in-tervention effects of Edaravone. Method Totally 72 Sprague-Dawley male rats were randomly divided into fourgroups:normal group (n = 6, group A) ,shame-operated group ( n = 6, group B), CPR group including 1 hour,6 hours, 12 hours, 24 hours, and 72 hours after ROSC (5 sub-groups, n = 6for each,group C) ,edaravone-treat-ed group with the same time points as CPR groups(5 sub-groups, n = 6for each,group D). Asphyxia cardiac ar-rest with CPR model was used in group C and group D. Edaravone at a dose of 3.0 mg/kg was given intravenouslyand the same dose of edaravone was administered subcutaneously to the rats of group D after CPR. Anaesthosia,vascular cannulation and endotracheal intubation were pedormed in rats without asphyxia and CPR in group B. Ateach interval, the brain water content was calculated. The AQP4 expression level in brain tissue was determinedusing immunohistocbemical staining. Neurodeficit scores were assessed and pathological change was observed, Re-sults The brain water content in rats of group C increased obviously along with the prolongation of time followingROSC,and reached its peak at ROSC 24h,which was much higher than that of group B (P<0.01). Meanwhile,AQP4 expression in brain had a trend towards increasing and the integral optical density(iOD) and coloratian arearatio(△S) in group C were significantly increased compared with group B ( P<0.01). The trend of changes wasnearly the same as that of the brain water content. The correlation analysis demonstrated that AQP4 expression levelsuch as iOD (r=0.858, P < 0.01 ) and △S ( r = 0.870, P < 0.01 ) were correlated with the brain watercontents apparently. Compared with group C, the brain water content was decreased obviously (P<0.05), iODand △S was down-regulated at the same lime (P<0.01) in group D. The neurodeficit scores increased (P <0.05) and pathological damage was dramatieaUy ameliorated. Conclusions AQP4 expression increased greatly inbrain after CPR and the relationship between AQP4 and brain edema was positively correlated. AQP4 may play arole in the formation of brain edema following CPR. Edaravone could attenuated brain edema after CPR in rats byway of inhibiting the expression of AQP4. It had neuroprotective effect.