Rafiei Hooman, Bahrami Nasrin, Meisami Amir Hossein, Azadifar Haniyeh, Tabrizi Shahrouz
Department of Emergency Medicine, Faculty of Medicine, Kermanshah University of Medical Science, Kermanshah, Iran.
Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Ann Med Surg (Lond). 2022 May 20;78:103832. doi: 10.1016/j.amsu.2022.103832. eCollection 2022 Jun.
Cardiopulmonary resuscitation (CPR) involves organized procedures performed on patients with cardiac arrest. CPR method and techniques can determine neurological outcomes of the patients. The aim of this study is to investigate the effect of epinephrine in combination with methylprednisolone on neurological complications and the need for vasopressor after resuscitation in patients with cardiac and respiratory arrest.
In this randomized control clinical trial, patients referred to (XXX) who suffered from cardiac arrest and required CPR were included. Patients were divided into two groups; intervention (methylprednisolone + epinephrine) and placebo (epinephrine + placebo). Patients' information was completed in a questionnaire based on demographic information, main objectives and important variables (neurological complication and the need for vasopressor) and SPSSv21 was used for statistical analysis.
A total of 347 patients were included in the study. The intervention and control group were not significantly different in terms of gender, age systolic and diastolic blood pressure, p > 0.05. CPC scores were also not significantly different among the two groups, p > 0.05.131 patients (37.8%) needed vasopressor after the intervention and 216 patients (62.2%) did not need vasopressor. The two groups were significantly different in terms of intervention (P = 0.021).
Glucocorticoid, methylprednisolone does not reduce the risk of neurological complications following CPR in cardiac arrest patients.
心肺复苏（CPR）涉及对心脏骤停患者实施的一系列有组织的操作。心肺复苏的方法和技术会影响患者的神经功能转归。本研究旨在探讨肾上腺素联合甲泼尼龙对心搏呼吸骤停患者复苏后神经并发症及血管升压药使用需求的影响。
在这项随机对照临床试验中，纳入了转诊至（XXX）且发生心脏骤停并需要进行心肺复苏的患者。患者被分为两组；干预组（甲泼尼龙 + 肾上腺素）和安慰剂组（肾上腺素 + 安慰剂）。基于人口统计学信息、主要目标和重要变量（神经并发症和血管升压药使用需求）通过问卷收集患者信息，并使用SPSSv21进行统计分析。
本研究共纳入347例患者。干预组和对照组在性别、年龄、收缩压和舒张压方面无显著差异，p > 0.05。两组的脑功能分类（CPC）评分也无显著差异，p > 0.05。干预后131例患者（37.8%）需要血管升压药，216例患者（62.2%）不需要血管升压药。两组在干预方面有显著差异（P = 0.021）。
糖皮质激素甲泼尼龙并不能降低心脏骤停患者心肺复苏后神经并发症的风险。
