Effect Evaluation Of Cardiopulmonary Resuscitation In Cardiac Arrest In Children By Using Utstein Model

Objective:Using the Utstein assessment model for cardiopulmonary resuscitation(CPR)to evaluate the characteristics of cardiac arrest in children’s hospitals,the factors influencing the success of CPR,the results of CPR,and the absence of rescue records,we look forward to further improving the effect and prognosis of CPR in children,standardizing rescue records,and providing multicenter research data on cardiac arrest in children.Methods:According to the children’s Utstein model,we made the Utstein form to retrospectively analyze the regularities of distribution of age,gender,occurrence time,original disease and initial heart rhythm of the children with cardiac arrest(CA)in our hospital from January 2013 to October 2017,and the results and influencing factors of CPR,and to calculate the missing data of the rescue records.The effect of primary resuscitation is evaluated by self circulation recovery.Results:According to the resuscitation results,they are divided into restoration of spontaneous circulation(ROSC)group and non-restoration of spontaneous circulation(non-ROSC)group.There are 61 cases(63.5%)in ROSC group and 35 cases(36.5%)in non-ROSC group.The ratio of male to female is 1.13:1.Among them 66(68.8%)cases are younger than 1 year of age,and 30(31.3%)cases are older than 1 year old.Gender has no statistically significant difference in ROSC rate.The effect of age on ROSC rate was statistically significant(χ2=5.958,P=0.015).The incidence of cardiac arrest in children’s hospital is higher in the morning 9:00-12:00 and winter spring seasons.Most of the primary disease is respiratory system diseases with higher ROSC rate.The most common initial heart rhythm in the occurrence of CA is bradycardia.In the course of cardiopulmonary resuscitation,the airway support was divided into three groups(endotracheal intubation,before CA,emergency tracheal intubation,only with air bag mask during CA)with no statistically significant differences in the effect of ROSC.In cardiopulmonary resuscitation,the frequency of adrenaline use less than 2 times was higher than that of more than 2 times,and the difference was statistically significant(χ2=25.098,P=0).Whether the effect of acid correcting on the recovery rate of spontaneous circulation during cardiopulmonary resuscitation was not statistically significant.The duration of CRP was(17.28 + 26.68)minutes and(61.29 + 30.81)minutes respectively in the ROSC group and non-ROSC group,with statistically significant difference(t=6.314,P=0.000).Logistic multivariate regression analysis shows that age less than 1 years,duration of CPR,frequency of adrenaline use are closely related to the ROSC rate(P<0.05).Height(68.8%),initial heart rhythm(16.7%),beginning time of CPR(14.6%),time of ROSC(21.2%),and assessment of life quality(100%)after ROSC have high loss rate in the rescue records.Conclusion:The cardiac arrest in the children’s hospital mostly happened in children no more than 1 year old.9:00-12:00 a.m.and winter spring seasons have higher CA incidence.Most of the primary disease is respiratory system diseases.The factors affecting the ROSC rate of CPR include:age no more than 1 year old,duration of CPR,and the frequency of epinephrine use.Datum of rescue records about height,initial heart rhythm,beginning time of CPR,time of ROSC,and assessment of life quality after ROSC miss more.