The relationship between neurofunctional prognosis and early mean arterial pressure after cardiopulmonary resuscitation / 中华急诊医学杂志

ABSTRACT

Objective:To discuss the relationship between neurofunctional prognosis and early mean arterial pressure (MAP) of patients with post-cardiac arrest syndrome (PCAS).Methods:This retrospective study enrolled 151 PCAS patients in Henan Provincial People’s Hospital between January 2016 and January 2018. A multivariate logistic regression analysis was established to determine the correlation between the MAP at the first 6 h and the prognosis of the patients at discharge. The effect of angioactive drugs on the neurofunctional prognosis of patients at discharge was determined by chi-square test.Results:The multivariate logistic regression analysis showed that the TWA-MAP of patients with good neurofunctional prognosis at discharge was significantly higher than that of patients with poor prognosis (83.25±13.69) mmHg vs (77.06±18.37) mmHg, P=0.042. In the first 6 h after ROSC, the neurofunctional prognosis of patients with good prognosis in the TWA-MAP value of 71 to 80 mmHg was significantly better than that of patients with TWA-MAP lower than 70 mmHg (11% vs 37%, P=0.009). The variable logistic regression analysis results showed that the level of TWA-MAP higher than 70 mmHg or 65 mmHg was the independent factor affecting the outcome, while the level of TWA-MAP higher than 70 mmHg had a better correlation with the neurofunctional prognosis ( OR=4.11, 95% CI1.34-12.66, P=0.014). In patients with TWA-MAP higher than 70 mmHg, the neurofunctional prognosis of patients with good prognosis but without angioactive drugs was significantly better than that of those with angioactive drugs (48% vs 24%, P=0.010). Conclusion:Holding TWA-MAP higher than 70 mmHg in the first 6 h after PCAS is helpful to improve the neurofunctional prognosis of patients at discharge.