Application Of Vasopressin In Cardiopulmonary Resuscition And The Implementation Of The Life Of Survial

BACKGROUND: Cardiac arrest is the common critical illness in emergency department, how to improve its success rate of cardiopulmonary resuscitation has been more and more important to doctors. Apart from the basic life support, drug use was also very important. Over the past several decades adrenaline was the mian drug during the cardiac-pulmonary resuscitation . regardless of the standard dose, or some scholars suggested the use of large doses was unable to effectively improve the recovery rate of spontaneous circulation and improve the prognosis of the patients. In recent years, vasopressin was widely used in cardiopulmonary resuscitation , it has been achieved certain results, but the results was varied. However, we were very disappointed to the results of the clinical course of the recovery. In addition to the above factors, the implementation of the life of survival played a very important role during the cardiopulmonary resuscitation.OBJECTIVE: To research the effect of administration of vasopressin combined with epinephrine on cardiopulmonary resuscitation(CPR). Provide a theoretical reference for vasopressin application in the cardiopulmonary resuscitation .Through one hour recovery success and failure recovery in the lives of patients linked to compare the implementation of a further understanding of the CPR, as well as the problems that existed areas where improvement was needed, how to further enhance the cardiopulmonary resuscitation center clinical success rate of reference.METHOD: Retrospective analysis in our hospital from January 2003 to October 2007 with the entry criteria, 83 cases were divided into adrenaline joint vasopressin group that who received 1 dose of intravenous epinephrine during cardiopulmonary resuscitation and than give 42 IU vasopressin, if recycling did not resume, each 3-5 min gives 1 mg epinephrine; adrenaline group patients who received 1 mg of intravenous epinephrine during cardiopulmonary resuscitation every 3-5 mins until cycle recovery. The survival rate in one hour ,the success ratio of CPR in 24 hours and the time of spontaneous rhythm of the heart restoration was monitored in each group. Patients were observed the average time of spontaneous rhythm, survival rate in one hour and the success ratio of CPR between the two subgroups(more than five minutes and less than five minutes group) ,and find the diffence of them.According to the Utstein style recovery mode results, 83 patients were divided into two groups namely bascilly survival group and the failure of the recovery group, linked through analysis and comparison of life, such as the implementation of part of the actual situation, identify a recovery of the reasons for the different results.RESULT: 1, The ratio spontaneous rhythm of the heart restoration is different between the vasopressin and epinephrine groups (64.00%and34.48%), and time of spontaneous rhythm of the heart restoration is 10.6±5.0min and 18.6±7.9min, there are significance differences between the two groups. But there are no significance differences between one hour and efficient recovery success rate. 2, There are no significance differences of one hour and efficient recovery between the two sub-groups (5 minutes recovery group and the recovery of more than 5 minutes) in vasopressin and epinephrine groups (P> 0.05). 3, There are no significance differences of the receiving defibrillation chance, the establishment of artificial airway time,the defibrillation interval between the bascilly survival and the failure CPR group(P <0.05).CONCLUSION: Vasopressin group can further enhance restoration of spontaneous rhythm rate, shorten the time of restoration of spontaneous rhythm, one hour recovery success rate and the success rate of recovery with increased, and do not show better results than epinephrine, regardless of the duration of CPR vasopressin are no better than those of the effect of adrenaline between the cardiac arrest patients. It is worth further exploration. It is very poor about the implemention of the life of survival which inluding the early cardiopulmonary resuscitation, early defibrillation, and the establishment of artificial airway and so on.