[1]马雪,周世辉.呼吸机潮气量和高压报警值参数设置在心肺复苏中的应用[J].中国医学物理学杂志,2021,38(8):1001-1004.[doi:DOI:10.3969/j.issn.1005-202X.2021.08.016]
 MA Xue,ZHOU Shihui.Application of parameter settings of ventilator tidal volume and high pressure alarm value in cardiopulmonary resuscitation[J].Chinese Journal of Medical Physics,2021,38(8):1001-1004.[doi:DOI:10.3969/j.issn.1005-202X.2021.08.016]
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呼吸机潮气量和高压报警值参数设置在心肺复苏中的应用()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
38卷
期数:
2021年第8期
页码:
1001-1004
栏目:
医学信号处理与医学仪器
出版日期:
2021-08-02

文章信息/Info

Title:
Application of parameter settings of ventilator tidal volume and high pressure alarm value in cardiopulmonary resuscitation
文章编号:
1005-202X(2021)08-1001-04
作者:
马雪周世辉
锦州医科大学附属第一医院急诊科, 辽宁 锦州 121000
Author(s):
MA Xue ZHOU Shihui
Department of Emergency, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China
关键词:
心博骤停心肺复苏呼吸机潮气量高压报警值
Keywords:
Keywords: cardiac arrest cardiopulmonary resuscitation ventilator tidal volume high pressure alarm value
分类号:
R459.7
DOI:
DOI:10.3969/j.issn.1005-202X.2021.08.016
文献标志码:
A
摘要:
目的:探讨呼吸机潮气量(VT)和高压报警值参数设置在心肺复苏(CPR)中的应用效果。方法:94例心搏骤停需实施心肺复苏治疗的患者作为研究对象,根据不同呼吸机潮气量和高压报警值参数设置,将所有纳入对象随机分为观察组和对照组,各47例。观察组呼吸机潮气量和高压报警值参数分别设置为6~7 mL/kg和60 cmH2O,对照组呼吸机潮气量和高压报警值参数分别设置为8~12 mL/kg和40 cmH2O,对比分析两组患者CPR治疗成功率、治疗过程中不同时间点乳酸水平、动脉血气[pH、氧饱和度(SaO2)、血氧分压(PaO2)、血二氧化碳分压(PaCO2)、碳酸氢根(HCO3-)]水平以及治疗后吸气峰压(PIP)水平、治疗后复苏即刻及复苏24 h后神经功能评分。结果:观察组患者CPR成功率为65.96%,显著优于对照组的42.55%([χ2]=5.187, P=0.023);观察组CPR后患者10、30 min时间点pH、PaO2、PaCO2及乳酸水平均显著低于对照组(P<0.05),SaO2、HCO3-显著高于对照组(P<0.05);观察组患者CPR后PIP、复苏时间显著低于对照组(P<0.05);复苏24 h后,观察组患者格拉斯哥昏迷评分和急性生理与慢性健康评分增加程度显著高于对照组(P<0.05)。结论:呼吸机采取低潮气量、上调高压报警值参数,可有效改善心搏骤停患者动脉血气指标,增加患者CPR成功率,缓解患者神经功能损伤,且未增加CPR后并发症发生风险。
Abstract:
Abstract: Objective To explore the application effect of parameter settings of ventilator tidal volume and high pressure alarm value in cardiopulmonary resuscitation (CPR). Methods A total of 94 patients undergoing CPR due to cardiac arrest were enrolled as the research subjects. According to different parameter settings of ventilator tidal volume and high pressure alarm value, they were randomly divided into observation group (6-7 mL/kg, 60 cmH2O) and control group (8-12 mL/kg, 40 cmH2O), with 47 cases in each group. The success rate of CPR, levels of lactic acid and arterial blood gas indexes [pH, oxygen saturation (SaO2), partial pressure of blood oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), bicarbonate (HCO3-)] during treatment, peak inspiratory pressure (PIP) after treatment, scores of neurological function immediately after resuscitation and at 24 h after resuscitation were compared between two groups. Results The success rate of CPR in observation group was significantly higher than that in control group (65.96% vs 42.55%) ([χ2]=5.187, P=0.023). At 10 min and 30 min after CPR, the pH value, PaO2, PaCO2 and level of lactic acid in observation group were significantly lower than those in control group (P<0.05), while SaO2 and HCO3- were significantly higher than those in control group (P<0.05). After CPR, the PIP and resuscitation time in observation group were significantly lower than those in control group (P<0.05). At 24 h after resuscitation, the score increases of Glasgow coma scale and acute physiology and chronic health evaluation-II in observation group were significantly faster than those in control group (P<0.05). Conclusion The low tidal volume and up-regulating high pressure alarm value in ventilator can effectively improve arterial blood gas indexes in cardiac arrest patients, increase success rate of CPR and alleviate neurological injury, without increasing complications risk after CPR.

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备注/Memo

备注/Memo:
【收稿日期】2021-03-17 【作者简介】马雪,在读博士研究生,主治医师,主要从事急诊医学、内分泌代谢疾病的临床与基础研究,E-mail: 85934541@qq.com 【通信作者】周世辉,硕士,主治医师,主要从事急诊医学,E-mail: 1060402586@qq.com
更新日期/Last Update: 2021-07-31