Lv Jun Hua, Wang Dan, Zhang Meng Na, Bai Zheng Hai, Sun Jiang-Li, Shi Yu, Pei Hong Hong, Zhang Zheng-Liang, Wang Hai
Emergency Department & EICU, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan Xi, Peoples' Republic of China.
Medicine (Baltimore). 2019 Feb;98(5):e14303. doi: 10.1097/MD.0000000000014303.
No matter in or outside hospital, the success rate of cardiopulmonary resuscitation (CPR) is very low. The sign of successful CPR is the recovery of spontaneous circulation. The premise of the recovery of spontaneous circulation is the recovery and maintenance of sinus rhythm, but there is still no related research.We aim to study the factors for the recovery and maintenance time of sinus rhythm in patients with CPR.A single-center retrospective case-control study.Ethical review was obtained (ethical approval number: 20180031).The second affiliated hospital of Xi'an Jiaotong University, Xi'an Shaanxi, China.From January 2011 to December 2016, totally 344 cases met the inclusion and exclusion criteria, sinus rhythm recovered group (SR group) (n = 130 cases), sinus rhythm unrecovered group (SUR group) (n = 214 cases).The multivariate logistic regression analysis showed that red blood cell counts (OR = 1.30, 95% CI:1.04-1.63, P = .02), rescue time (OR = 0.95, 95% CI:0.94-0.97, P <.001), the usage of norepinephrine (OR = 2.14, 95% CI:1.06-4.35, P = .04) were important factor for the recovery of sinus rhythm in patients with CPR. Multivariate linear regression analysis showed that the dosage of epinephrine, the usage of naloxone and diagnosis were important factors for maintenance time of sinus rhythm after resuscitation, P <.05. The rescue time had high accuracy to predict the recovery of sinus rhythm, the area under the receiver operator characteristic (ROC) curve (AUC) was 0.84 (0.80, 0.88), sensitivity and specificity are respectively 71.54% and 93.46%.Red blood cell counts, the rescue time and the usage of norepinephrine might be important factors for the recovery of sinus rhythm, and the dosage of epinephrine, the usage of naloxone and the diagnosis might be important factors for the maintenance time of sinus rhythm in patients with CPR.
无论在医院内还是医院外,心肺复苏(CPR)的成功率都很低。CPR成功的标志是自主循环恢复。自主循环恢复的前提是窦性心律的恢复和维持,但目前尚无相关研究。我们旨在研究CPR患者窦性心律恢复及维持时间的相关因素。一项单中心回顾性病例对照研究。已获得伦理审查(伦理批准号:20180031)。中国陕西西安西安交通大学第二附属医院。2011年1月至2016年12月,共有344例患者符合纳入和排除标准,分为窦性心律恢复组(SR组)(n = 130例)和窦性心律未恢复组(SUR组)(n = 214例)。多因素logistic回归分析显示,红细胞计数(OR = 1.30,95%CI:1.04 - 1.63,P = 0.02)、抢救时间(OR = 0.95,95%CI:0.94 - 0.97,P < 0.001)、去甲肾上腺素的使用(OR = 2.14,95%CI:1.06 - 4.35,P = 0.04)是CPR患者窦性心律恢复的重要因素。多因素线性回归分析显示,肾上腺素剂量、纳洛酮的使用及诊断是复苏后窦性心律维持时间的重要因素,P < 0.05。抢救时间对预测窦性心律恢复具有较高的准确性,受试者工作特征(ROC)曲线下面积(AUC)为0.84(0.80,0.88),敏感性和特异性分别为71.54%和93.46%。红细胞计数、抢救时间及去甲肾上腺素的使用可能是CPR患者窦性心律恢复的重要因素,而肾上腺素剂量、纳洛酮的使用及诊断可能是CPR患者窦性心律维持时间的重要因素。