Ghanbari Khanghah Atefeh, Moghadamnia Mohammad Taghi, Panahi Latif, Pouy Somaye, Aghajani Nargesi Marjan, Kazemnezhad Leyli Ehsan
Professor, Social Determinants of Health Research Center (SDHRC), Department of Nursing and Midwifery (Medical- Surgical), Guilan University of Medical Sciences, Rasht, Iran.
Department of Medical Surgical Nursing, School of Nursing and Midwifery, Guilan University of medical Sciences, Rasht, Iran.
Arch Acad Emerg Med. 2022 Jul 16;10(1):e57. doi: 10.22037/aaem.v10i1.1678. eCollection 2022.
Standard cardiopulmonary resuscitation (STD-CPR) is successful in only 10-15% of cases in emergency department (ED). This study aimed to determine the effect of interposed abdominal compression (IAC) during resuscitation on outcomes of ED cardiac arrests.
In this randomized clinical trial study, non-trauma patients aged 18-85 years, patients with in-hospital cardiac arrest hospitalized in the ED were randomly assigned into two either STD-CPR or IAC-CPR group on a 1:1 basis and using computer-generated random numbers. Participants in the intervention group, received abdominal compression during the diastole phase of STD-CPR. The rate of return of spontaneous circulation (ROSC), heart rate (HR), respiratory rate (RR), arterial blood gas (ABG) indicators, and survival rate were compared between the two groups.
Ninety patients were enrolled (45 in each group). There were no differences between the two groups regarding age (p = 0.76), sex (p = 0.39), employment status (p = 0.62) and Charlson comorbidity scale (p = 0.46). Abdominal compression had a positive effect on heart rate (p < 0.001), mean arterial pressure (p = 0.003), arterial blood oxygen pressure (p = 0.001), and arterial blood carbon dioxide pressure (p = 0.001) as well as a negative effect on arterial blood oxygen saturation (p = 0.029) 30 minutes after resuscitation. Out of the 90 CPR cases, 8 (17.7%) cases in intervention group and 8 (17.7%) cases in control group were successful, among which all of the 8 patients in the intervention group and 5 of the patients in the control group had been discharged from hospital without any complications.
The results showed that abdominal compression during CPR can improve resuscitation outcomes in patients with cardiac arrest. Therefore, in order to use this technique, further research is recommended.
在急诊科(ED),标准心肺复苏(STD-CPR)仅在10%-15%的病例中成功。本研究旨在确定复苏期间进行腹部按压(IAC)对急诊科心脏骤停患者结局的影响。
在这项随机临床试验研究中,年龄在18-85岁的非创伤患者,即急诊科住院的院内心脏骤停患者,使用计算机生成的随机数按1:1的比例随机分为STD-CPR组或IAC-CPR组。干预组的参与者在STD-CPR的舒张期接受腹部按压。比较两组的自主循环恢复(ROSC)率、心率(HR)、呼吸频率(RR)、动脉血气(ABG)指标和生存率。
共纳入90例患者(每组45例)。两组在年龄(p = 0.76)、性别(p = 0.39)、就业状况(p = 0.62)和Charlson合并症量表(p = 0.46)方面无差异。复苏30分钟后,腹部按压对心率(p < 0.001)、平均动脉压(p = 0.003)、动脉血氧分压(p = 0.001)和动脉血二氧化碳分压(p = 0.001)有积极影响,对动脉血氧饱和度有负面影响(p = 0.029)。在90例心肺复苏病例中,干预组有8例(17.7%)成功,对照组有8例(17.7%)成功,其中干预组的8例患者和对照组的5例患者均已出院,无任何并发症。
结果表明,心肺复苏期间进行腹部按压可改善心脏骤停患者的复苏结局。因此,为了应用该技术,建议进一步研究。