The Survival Effect Of Adaptive Support Ventilation In Patients After CPR

Background: Cardiac arrest is the abrupt termination of cardiac ejection function, aortic pulse and heart sounds disappear, vital organs such as severe cerebral ischemia, hypoxia, resulting in termination of life. This unexpected sudden death, sudden death, also known as medical. Our annual incidence of sudden cardiac death rate was 0.04%, the number of people die each year from sudden cardiac death as high as 544,000. The incidence of sudden, rapid progress, with unpredictable characteristics, the occurrence of cardiac arrest patients after CPR survival rate less than 5%, It is critical to the success of recovery in patients with cardiac arrest on life support Although it is not necessarily associated cardiac arrest with respiratory arrest, but even patients without breathing in cardiac arrest, basic life support also need to follow the requirements of an open airway, although some patients still have weak breathing, if have not effective CPR, the spontaneous breathing rapid disappear.although mouth to mouth breathing can improve the success rate of cardiopulmonary resuscitation, but can not provide high concentrations of oxygen, and endotracheal intubation, mechanical ventilation can provide pure oxygen to patients.It can improve the blood oxygen pressure, increasing the solubility of oxygen in arterial blood, increased body oxygen delivery, it is beneficial for ventricular fibrillation cardioversion and maintenance of heart and circulation and contribute to brain recovery and improve the success rate of cardiopulmonary resuscitation. Therefore, mechanical ventilation has become the treatment of patients with cardiac arrest as a necessary means. With computer technology, high-precision micro-sensors (pressure and flow sensors), rapid response valve (valve) systems and other advanced technology applications in the field of ventilation machine, ventilator constantly upgrading, the new mode of ventilation after another, and gradually become intelligent; closed-loop control theory and applications to further improve its penetration into the various parts of mechanical ventilation. Closed-loop control theory and computer technology in the field of organic combination of mechanical ventilation, making the new ventilation modes and theoretical innovation. ASV closed-loop mode developed in recent years as a new type of intelligent ventilation, it can based on the patient states transferred from the pressure control ventilation to pressure support ventilation, while ensuring a relatively constant minute ventilation.ASV both on the spontaneous breathing stage or in the mandatory minute ventilation.ASV can always be self-adjustment whether in pressure support level or the pressure control level.Although the ASV maintain its minute ventilation, the minute ventilation were not dependent on the patients trigger, it is theoretically possible to improve the human antagonist, reduced work of breathing. However,few reports about patients after cardiopulmonary resuscitation used ASV mode,and the study about successful rate of CPR is not in depth.Objective:This study of adaptive support ventilation (ASV) mode used in cardiac arrest patients during cardiopulmonary resuscitation by monitoring hemodynamic parameters, respiratory mechanics parameters, the success rate of cardiopulmonary resuscitation, weaning time, and with conventional ventilation and other indicators mode compared to models of ASV for the superiority of cardiopulmonary resuscitation.Methods: Select from the April 2009 to September 2010 in the jilin university Unit chinese-japanese hospital emergency room and ICU patients(include57 cases of CA treated patients) the patients were using ASV mode Noted or ASV group. Meanwhile select from 2007 to 2009 review by traditional breathing pattern(PCV,VCV,SIMV mode)or CPCR treatment, the 64 patients of CA with traditional ventilation were noted for traditional mode.After each ventilation mode application, record its respiratory mechanics index: breathing rate, volume tide, airway average pressure, airway peak pressure, inspiratory flow velocity and expiratory flow velocity, inspiratory resistance, expiratory resistance, simultaneous determination of blood pressure and heart arterial rate through extraction of arterial bloodResults:Compared with the traditional model group, ASV group volume tide obviously increases, breathing frequency obviously , inspiratory resistance and exhale resistance are more decreses, inspiratory velocity flow significantly higher than the traditional mode group, expiratory velocity flow obviously lower than the traditional mode group.cardiopulmonary resuscitation and brain recovery success rate of ASV groups of patients obviously higher than the traditional mode.the time of Ventilator weaning significantly shortened than the traditional mode, the heart rate and mean arterial pressure of ASV groups of patients were significantly lower than the traditional mode group.Conclusion: Compared with traditional ventilation (PCV, VCV and SIMV mode) for cardiac arrest patients during cardiopulmonary resuscitation in the use of ASV mode of mechanical ventilatory support it can significantly improve success rate of cardiopulmonary resuscitation and cerebral resuscitation and can significantly shorten the recovery time of cardiopulmonary resuscitation to the heart and weaning time. ASV mode with good lung protection, to improve respiratory mechanics parameters, including peak airway pressure decreased mean airway pressure, lower inspiratory resistance and expiratory resistance, improve inspiratory flow and expiratory flow rate; its ability to rapidly improve oxygenation increase the tidal volume and respiratory rate slow down to achieve the deep slow breathing better oxygenation and thus to avoid acid-base balance, while ensuring effective ventilation, air pressure can be effective in preventing the occurrence of injury and injury volume, and work of breathing consumption minimum. ASV mode to improve the role of hemodynamics, by slowing the heart rate decrease myocardial oxygen consumption, mean arterial pressure by reducing the prevention of cerebral edema, thus contributing to cardio-pulmonary resuscitation and brain recovery.