| Objective:To investigate the guiding role of thoracic electrical bioimpedancenoninvasive hemodynamic monitoring application of vasoactive drugs in the treatmentof CPR restoration of spontaneous circulation，and protection of organ function inpatients after cardiopulmonary resuscitation significance.Methods:Select13cases during2012.1-2012.12in our hospital hospitalizedpatients with no previous history of structural heart and cardiac dysfunction suddencardiac arrest,return of spontaneous circulation after actively rescue and survival inpatients with more than72hours. Selected cases were randomly divided intoexperimental group and the control group, experimental group in7cases,6cases of thecontrol group, each group of patients was not statistically significant differences ingender, age, body weight, and treatment of the primary disease and life-saving treatmentat the same time.The experimental group according to the CO of thoracic impedancemethod noninvasive hemodynamic monitoring to adjust the time and dose of applicationof vasoactive drugs, control group according to the changes in the peripheral bloodpressure by conventional methods to adjust the application of time-and dose ofvasoactive drugs. Each group specimens from0minutes,1H,6h,12h,24h,48h,72hmonitoring of CO, CI, SV, SI, ACI, VI, LVET, STR, PEP value; specimens venousblood at each time point by the dry chemical method of laboratory test specimens fromCK, CK-MB, hs-TnI and BNP values,specimens arterial blood to sacrific blood LACvalue at the point-of-care blood gas analyzer; specimens the CVP value at thebedside,and assess brain function in patients with GCS score.Results: The0min experimental group and control group data monitoring, therewas no significant difference;1h experimental group, heart rate (HR) lower than that incontrol group, P <0.05, there is significant difference;6h,12h,24h,48h and72h experimental group CO, CI, SV, SI, ACI, VI higher than that in control group, P <0.05,there is significant difference;12h,24h,48h and72h experimental group LVET higherthan that in control group, P <0.05, there is significant difference;6h,12h,24h,48h and72h experimental group STR shorter than that in control group, P <0.05, there issignificant difference;24h experimental group PEP shorter than that in control group, P<0.05, there is significant difference;6h experimental group CK lower than that incontrol group, P <0.05, there is significant difference;6h,12h,24h,48h and72hexperimental group, CK-MB and hs-TNI compared with the control group, P>0.05, notstatistically significant.24h,48h,72h experimental group BNP lower than that incontrol group, P <0.05, there is significant difference;6h,12h,24h,48h and72hexperimental group LAC lower than that in control group, P <0.05, there is significantdifference;12h,24h,48h and72h experimental group CVP lower than that in controlgroup, P <0.05, there is significant difference;12H,24h,48h and72h experimentalgroup GCS higher than that in control group, P <0.05, there is significant difference.Conclusions: Thoracic electrical bioimpedance noninvasive hemodynamicmonitoring can effectively guide the application of vasoactive drugs duringcardiopulmonary resuscitation after cardiac arrest, increase the blood flow to the heart,accelerated ischemia and hypoxia damaged myocardial cell recovery, increasedmyocardial ejection function, increase in cardiac output, reduce the degree of heartfailure, promote the recovery of cardiac function; increase cerebral blood flow supplyand reduce cerebral ischemia time, reduce the time of ischemia and reperfusion, reducebrain tissue ischemia-reperfusion injury, protect brain cells, promote the recovery ofbrain function in patients; reduce blood lactate levels as early as possible to reducetissue hypoxia, conducive to oxygen metabolism balance and a stable internalenvironment of the body, improve patient prognosis restore。It is important to theprotection of organ function in patients after cardiopulmonary resuscitation. |
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