| Objective:no reasonable conclusion has been reached as to the time frame for the resuscitation of patients with in-hospital Cardiac Arrest(IHCA).In this study,whether the half-hour resuscitation time is reasonable was analyzed,and the correla-tion between the duration of resuscitation and prognosis was studied.Methods:In January 2015 to January 2019 in our hospital emergency department in patients with cardiac arrest for study,patients with complete clinical information collection,all patients were received cardiopulmonary Resuscitation(CPR)(Cardio Pulmonary Resuscitation,or CPR,and according to the length of time of patients of cardiopulmonary Resuscitation(CPR)group,30 minutes and divided into normal group,the group is divided into more than 30 minutes long,the general data of two groups of patients,compares and analyses the causes and prognosis in addition according to the causes of patients with initial rhythm of the heart,age,gender,for further packet,The spontaneous circulation of spontaneous circulation(ROSC)in each group was compared.According to the methods of patients receiving cardiopulmonary resuscitation(CPR),the patients were divided into the freehand cardiopulmonary resuscitation(CPR)group and the freehand sequential cardiopulmonary resuscitation(CPR)group.Results:(1)a total of 135 subjects were included in this study,including 86 males(63.70%)and 49 females(36.30%),with an average age of 60.53 15.46 years(45-76 years).Among them,28 patients with defibrillation heart rhythm,accounting for 20.74%.There were 50 cases of central vascular disease,accounting for 37.04%;4 cases of gastrointestinal bleeding,accounting for 2.96%;29 cases of respiratory disease,accounting for 21.48%;7cases of cerebral apoplexy,accounting for 5.19%;9 cases of trauma,accounting for 6.67%;6 cases of sepsis,accounting for 4.44%;and other cases,accounting for 22.22%.Among them,23 patients had acute myocardial infarction,accounting for 46% of all cardiovascular diseases.70 cases(51.85%)received unarmed cardiopulmonary resuscitation.Sixty-five patients(48.15%)received CPR by hand.(2)among the 135 patients,58 patients(42.96%)showed recovery of autonomic circulation,and 7 patients were discharged with survival rate of 5.19%,which was statistically significant.The analysis found that compared with the characteristics of the overall recovery time distribution,the recovery time distribution of patients with autonomic circulation recovery showed a left shift,while compared with the characteristics of the recovery time distribution of patients with autonomic circulation recovery,the recovery time of patients with survival and discharge further moved to the left of the distribution,that is,the recovery time was gradually shortened.The analysis shows that the recovery time of patients with autonomic cycle recovery is mostly concentrated in 0-40 minutes.After the recovery time exceeds 25 minutes,the number of patients with autonomic cycle recovery slowly decreases,and a small peak of autonomic cycle recovery occurs again when the recovery time is 1 hour to 1.5 hours.The analysis found that there was a linear relationship between discharge survival rate and discharge time of patients with resuscitation time kept within half an hour,and patients with resuscitation time longer than half an hour were all dead in the end.(3)61 cases(45.19%)in the conventional resuscitation group whose recovery time was less than half an hour;There were 74 cases(54.81%)in the super-long resuscitation group whose recovery time was longer than half an hour.There were no statistically significant differences in gender,age,and basal heart rate between the conventional resuscitation group and the ultra-long resuscitation group(P>0.05).According to the analysis of the etiology of cardiac arrest,there was no statistical significance in the comparison of the results of each subgroup(P>0.05).Thirty-six patients in the conventional resuscitation group received CPR with bare hands,accounting for 59.02%,and 25 patients received CPR with bare hands,accounting for 40.98%(P>0.05).In the ultra-long cardiopulmonary resuscitation group,34 patients received unarmed cardiopulmonary resuscitation(45.95%),and 40 patients received unarmed sequential cardiopulmonary resuscitation(54.05%)(P>0.05).The main outcome analysis showed that 41 patients(67.21%)in the conventional resuscitation group recovered autonomic circulation.In the ultra-long resuscitation group,17 patients recovered autonomic circulation,accounting for 22.97%(P>0.05).Analysis of secondary outcomes showed that 7 patients(11.48%)in the conventional resuscitation group recovered from autonomic circulation.In the ultra-long resuscitation group,no patients survived and were discharged without recovery of autonomic circulation(P>0.05).(4)among the 58 patients(42.96%)with recovery of autonomic circulation,35 were males and 23 were females.The average length of cardiopulmonary resuscitation(CPR)was 17.6 13.6 minutes.The average length of cardiopulmonary resuscitation(CPR)time for women with recovery of spontaneous circulation was 16.6 12.0 minutes,with no statistical difference(P>0.05).Among the 58 patients with autonomic circulation recovery,there were 10 patients with defibrillation heart rhythm(17.24%)and 45 patients with defibrillation heart rhythm(77.58%),among which,the average length of resuscitation time for patients with defibrillation heart rhythm recovery with autonomic circulation recovery was(21.2 8.3)minutes,and the average time for patients with defibrillation heart rhythm was(16.0 13.9)minutes,which was not statistically significant(P>0.05).All patients were divided into groups according to age,including 20-29 years old,30-39 years old,40-49 years old,50-59 years old,60-69 years old,70-79 years old,and over 80 years old.Comparative analysis of the recovery time of these groups showed no statistical significance(P>0.05).(5)according to the grouping cause for cerebral apoplexy group,acute myocardial infarction,pulmonary embolism,trauma group,arrhythmia,severe pneumonia,sepsis,heart failure group,based on the groups of patients of cardiopulmonary resuscitation(CPR)length is analyzed,found that trauma patients of spontaneous circulation restoration recovery and heart failure,arrhythmia and pulmonary embolism in patients with spontaneous circulation recovery recovery time difference is obvious(P<0.05);There were significant differences in the length of recovery between patients with pulmonary embolism and those with recovery of autonomic circulation,including sepsis,acute myocardial infarction,stroke,heart failure,arrhythmia,severe pneumonia,and traumatic autonomic circulation(P<0.05).(6)among 135 patients,70 cases(51.85%)were resuscitated by hand,and the recovery rate of autonomic circulation was 44.29%.65 cases(48.15%)were resuscitated by freehand sequential cardiopulmonary resuscitation machine,and the recovery rate of autonomic circulation was 41.54%(P>0.05).Conclusions:1.Prolonged cardiopulmonary resuscitation can improve the recovery rate of spontaneous circulation in patients with hospital cardiac arrest,but can not improve the survival rate of patients;2.2.If clinically diagnosed or highly suspected of pulmonary embolism,prolonged cardiopulmonary resuscitation can improve the recovery rate of patients’ autonomic circulation;3.Unarmed resuscitation cannot improve the recovery rate of patients’ spontaneous circulation compared with the sequential CPR with unarmed resuscitation,but the application of unarmed resuscitation and sequential CPR can reduce the labor intensity of medical staff and reduce the risk of doctor-patient disputes. |
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