Clinical study of TCD combined with APACHE II scores in the prognosis of neurologic outcome after the active abdominal compression-decompression cardiopulmonary resuscitation

doi:10.3877/cma.j.issn.2095-9133.2018.01.004

Chinese Journal of Hygiene Rescue(Electronic Edition) ›› 2018, Vol. 04 ›› Issue (01): 21-25. doi: 10.3877/cma.j.issn.2095-9133.2018.01.004

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Clinical study of TCD combined with APACHE II scores in the prognosis of neurologic outcome after the active abdominal compression-decompression cardiopulmonary resuscitation

Yingxin Cen¹, Sisen Zhang²^,^†(), Hongwei Wang¹, Ting Liu¹, Longxian Zhao³, Cunqing Zhang⁴, Jing Li⁴, Lixiang Wang⁵

^1. Department of Emergency, The Second School of Clinical Medicine, Southern Medical University, Affiliated Zhengzhou People’s Hospital, Zhengzhou 450003, China
^2. Department of Emergency, The Second School of Clinical Medicine, Southern Medical University, Affiliated Zhengzhou People’s Hospital, Zhengzhou 450003, China; Zhengzhou People’s Hospital Emergency Medical Center, Zhengzhou 450003, China
^3. Sanmenxia city central hospital Emergency Medical Center, Sanmenxia 450003, China
^4. Beijing Germari Medical Equipment Co., Ltd, Beijing 100038, China
^5. Emergency Medical Center, General Hospital of Chinese Armed Police Forces, Beijing 100039, China

Received:2018-01-28 Online:2018-02-18 Published:2018-02-18
Contact: Sisen Zhang
About author:
Corresponding author: Zhang Sisen, Email: 2362176700@qq.com

Abstract

Abstract:

Objective

The aim of the study was to demonstrate that TCD and APACHE II scores can be used as predictors of the neurologic outcome after abdominal cardiopulmonary resuscitation.

Methods

A retrospective study was performed in a total of 66 cardiac arrest patients with abdominal cardiopulmonary resuscitation in Zhengzhou People’s Hospital and Sanmenxia center hospital were selected. There were 34 males and 32 females, whose age ranged from 19 years old to 80 years old with the mean age of 50.91±14.50 years. According to the Glasgow-Pittsburgh cerebral performance categories, the patients were divided into favorable prognosis group with the CPC1~2(n=29)and unfavorable prognosis group with the CPC3~5 (n=37). Two groups of patients’CBF by TCD and APACHEⅡ scores were compared in 24 hours after successful abdominal cardiopulmonary resuscitation. The date was analyzed and receiver operating characteristic curves were made.

Results

CBF of favorable prognosis group was higher than that of unfavorable prognosis group[(6.23±1.88)vs(4.88±1.15), P<0.05], and APACHEⅡ scores was lower than that of unfavorable prognosis group[(15.31±5.37)vs(25.05±7.94), P<0.05]. CBF had negative correlation with APACHEⅡ scores(R=-0.692, P<0.01). ROC curves for unfavorable prognosis patients revealed an area under the curve of 0.722 for CBF, and 0.844 for APACHEⅡ scores.

Conclusion

The increasing CBF and decreasing APACHEⅡ scores were observed in patients with good outcome in brain function. So CBF and APACHEⅡ scores can be used as predictors of the brain function after abdominal cardiopulmonary resuscitation.

Key words: Abdominal cardiopulmonary resuscitation, Transcranial doppler ultrasound( TCD ), Cerebral blood flow( CBF ), APACHEⅡ scores, Glasgow-Pittsburgh cerebral performance categories(CPC)

Yingxin Cen, Sisen Zhang, Hongwei Wang, Ting Liu, Longxian Zhao, Cunqing Zhang, Jing Li, Lixiang Wang. Clinical study of TCD combined with APACHE II scores in the prognosis of neurologic outcome after the active abdominal compression-decompression cardiopulmonary resuscitation[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2018, 04(01): 21-25.

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Figures/Tables 5

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级别	神经功能表现	临床表现
1	脑功能完好	意识清醒警觉，有正常的生活和工作能力，可能有轻度心理功能缺陷、轻度语言障碍、不影响功能的轻度偏瘫或轻微颅脑神经功能异常
2	中度脑功能残疾	意识清醒，可在特定环境中部分时间工作或独立完成日常活动，可能存在偏瘫、癫痫发作、共济失调、构音困难、言语障碍、永久性记忆或心理改变
3	严重脑功能残疾	清醒，但需依赖他人的日常帮助，保留有限的认知力，或可以行动，但严重记忆紊乱，或痴呆，或瘫痪而仅依赖眼睛交流
4	昏迷及植物状态	无知觉，对环境无意识，无认知力，不存在与周围环境的语言或心理的相互作用
5	死亡	被确认脑死亡或传统标准认定的死亡

级别	神经功能表现	临床表现
1	脑功能完好	意识清醒警觉，有正常的生活和工作能力，可能有轻度心理功能缺陷、轻度语言障碍、不影响功能的轻度偏瘫或轻微颅脑神经功能异常
2	中度脑功能残疾	意识清醒，可在特定环境中部分时间工作或独立完成日常活动，可能存在偏瘫、癫痫发作、共济失调、构音困难、言语障碍、永久性记忆或心理改变
3	严重脑功能残疾	清醒，但需依赖他人的日常帮助，保留有限的认知力，或可以行动，但严重记忆紊乱，或痴呆，或瘫痪而仅依赖眼睛交流
4	昏迷及植物状态	无知觉，对环境无意识，无认知力，不存在与周围环境的语言或心理的相互作用
5	死亡	被确认脑死亡或传统标准认定的死亡

组别	例数(例)	PI值	脑血流	APACHEⅡ评分(分)
预后良好组	29	1.36±0.88	6.23±1.88	15.31±5.37
预后不良组	37	1.93±0.62	4.88±1.15	25.05±7.94
t值	?	－3.08	3.41	－4.95
P值	?	<0.05	<0.05	<0.05

组别	例数(例)	PI值	脑血流	APACHEⅡ评分(分)
预后良好组	29	1.36±0.88	6.23±1.88	15.31±5.37
预后不良组	37	1.93±0.62	4.88±1.15	25.05±7.94
t值	?	－3.08	3.41	－4.95
P值	?	<0.05	<0.05	<0.05

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