Effects of subhypothermia after cardiopulmonary resuscitation on hemodynamics and cytokines in patients with cardiac arrest

doi:10.3877/cma.j.issn.2095-9133.2021.01.005

Abstract

Abstract:

Objective

To investigate the effects of subhypothermia on hemodynamics and cytokines after cardiopulmonary resuscitation in patients with cardiac arrest.

Methods

Eighty cases of cardiac arrest patients after cardiopulmonary resuscitation in our hospital were randomly divided into the observation group (40 cases) and the control group (40 cases) for prospective study. The control group was treated with conventional treatment, and the observation group was treated with mild hypothermia on the basis of the control group. Vital signs, hemodynamic parameters, post-resuscitation syndrome, CRP, IL-6 and IL-8 levels, and the incidence of adverse reactions were compared between the two groups.

Results

After 24h of mild hypothermia treatment, the heart rate and spontaneous respiration rate of the observation group were lower than that of the control group (P<0.05), while the comparison of oxygen saturation and hemodynamic parameters between the two groups showed no statistical significance (P>0.05). The serum levels of CRP, IL-6 and IL-8 in the observation group were decreased to different degrees compared with the control group (P<0.05).

Conclusion

Mild hypothermia treatment can effectively reduce the body inflammatory response, reduce the incidence of post-resuscitation syndrome and improve the prognosis.

Key words: Cardiopulmonary resuscitation, Hemodynamics, Cytokines, Low temperature, CRP

Kangrong Li, Nating Lai, Mingyu Yang, Hangyu He. Effects of subhypothermia after cardiopulmonary resuscitation on hemodynamics and cytokines in patients with cardiac arrest[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2021, 07(01): 26-29.

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References 21

1	Soar J, Maconochie I, Wyckoff MH, et al.2019 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations[J]. Resuscitation, 2019, 145: 95-150.
2	朱文生．亚低温联合生脉注射液对心脏骤停后脑复苏患者心脑功能的保护作用[J]．解放军预防医学杂志，2018，36(6)：720-723.
3	张丽，郭红，李丽丽．心肺复苏患者临床特点及自主循环复苏成功率的临床分析[J]．医学综述，2016，22(24)：4953-4956.
4	赵春香，郑艳安，王瑞刚．亚低温疗法联合参附注射液治疗心脏骤停后脑复苏患者的疗效[J]．实用临床医学，2018，19(8)：8-11.
5	陈红，刘淑梅，丁丽萍．亚低温治疗在心肺脑复苏中的临床应用效果及护理[J]．中国实用医药，2014，9(29)：213-214.
6	李莉莉．亚低温治疗在心肺脑复苏中的实施及护理[J]．齐鲁护理杂志，2013，19(05)：52-54.
7	保学明，卢建华，黄梦国，等．亚低温保护心跳骤停复苏后大鼠心脏功能并提高其生存率[J/CD]. 中华卫生应急电子杂志，2015，1(4)：270-272.
8	Weitzel LR, Sampath D, Shimizu K, et al.EEG power as a biomarker to predict the outcome after cardiac arrest and cardiopulmonary resuscitation induced global ischemia[J]. Life Sci, 2016, 165: 21-25.
9	Zhao JK, Guan FL, Duan SR, et al.Effect of focal mild hypothermia on expression of MMP-9, TIMP-1, Tau-1 and beta-APP in rats with cerebral ischaemia/reperfusion injury[J]. Brain Inj, 2013, 27(10): 1190-1198.
10	郭文丰．亚低温治疗在神经系统疾病和心脏骤停复苏中的临床应用效果观察及有效性分析[J/CD]．临床医药文献电子杂志，2019，6(68)：60-61.
11	黄达，梁剑峰，朱曦，等．心脏骤停复苏后患者体温对脑功能预后的影响[J]．临床麻醉学杂志，2016，32(6)：567-572.
12	Kawamura N, Schmeichel AM, Wang Y, et al.Multiple effects of hypothermia on inflammatory response following ischemia-reperfusion injury in experimental ischemic neuropathy[J]. Exp Neurol, 2006, 202(2): 487-496.
13	邓磊，杨鹏，常莉．血液学指标在评估心肺复苏成功患者预后中的临床价值[J]．川北医学院学报，2017，32(4)：564-566.
14	Piironen K, Tiainen M, Mustanoja S, et al.Mild hypothermia after intravenous thrombolysis in patients with acute stroke: a randomized controlled trial[J]. Stroke, 2014, 45(2): 486-491.
15	Roobol A, Roobol J, Carden MJ, et al.Ataxia-telangiectasia mutated and Rad3-related kinase (ATR) is activated by mild hypothermia in mammalian cells and subsequently activates p53[J]. Biochem J, 2011, 435(2): 499-508.
16	叶志其，游丽，黄建斌，等．颅脑损伤患者急性期血液中炎性因子的变化及意义[J]．中国现代医学杂志，2012，22(19)：58-60.
17	何景招，马中富，姚一鸣，等．PI、血清NSE和炎症介质对脑复苏患者预后的预测价值[J]．热带医学杂志，2015，15(12)：1644-1647.
18	马君武，俞欣，黄永华．早期机械通气配合亚低温治疗重型颅脑损伤的疗效及对血清C反应蛋白水平的影响[J]．中国老年学杂志，2013，33(19)：4730-4731.
19	王彬，崔志堂，闫俊杰，等．脑出血患者发病早期血液中C反应蛋白水平对病情及预后的影响[J]．中医学报，2014(29)：554.
20	王珍，管双仙，李国民．高血压脑出血患者血浆氨基末端脑利钠肽前体和C反应蛋白变化的临床意义[J/CD]．中华卫生应急电子杂志，2018，4(2)：81-83.
21	蔡曙洲，董伟，付汉东，等．血清C反应蛋白在颅脑损伤中的临床意义[J]．中国临床神经外科杂志，2012，17(5)：293-294.

组别	例数	心率(次/min)	呼吸频率(次/min)	血氧饱和度(%)
观察组	40	76.57±9.36	17.12±4.74	95.18±4.69
对照组	40	85.34±11.19	19.85±5.91	96.47±3.18
t值		3.80	2.28	1.44
P值		<0.05	<0.05	>0.05

组别	例数	心率(次/min)	呼吸频率(次/min)	血氧饱和度(%)
观察组	40	76.57±9.36	17.12±4.74	95.18±4.69
对照组	40	85.34±11.19	19.85±5.91	96.47±3.18
t值		3.80	2.28	1.44
P值		<0.05	<0.05	>0.05

组别	例数	MAP(mmHg)	SBP(mmHg)	DBP(mmHg)	CVP(mmH₂O)
观察组	40	75.79±9.73	108.83±12.71	71.13±7.63	67.10±10.56
对照组	40	79.32±8.53	111.32±10.85	73.56±9.14	69.81±10.12
t值		1.725	0.942	1.291	1.172
P值		>0.05	>0.05	>0.05	>0.05

组别	例数	MAP(mmHg)	SBP(mmHg)	DBP(mmHg)	CVP(mmH₂O)
观察组	40	75.79±9.73	108.83±12.71	71.13±7.63	67.10±10.56
对照组	40	79.32±8.53	111.32±10.85	73.56±9.14	69.81±10.12
t值		1.725	0.942	1.291	1.172
P值		>0.05	>0.05	>0.05	>0.05

组别	例数	CRP(mg/L)		IL-6(pg/mL)		IL-8(pg/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	40	11.73±2.54	6.81±1.29	77.18±6.70	43.21±8.28	54.47±7.52	36.98±7.84
对照组	40	11.20±1.78	8.62±1.96	76.82±6.85	55.82±9.07	55.39±8.89	45.57±5.13
t值		1.08	4.88	0.24	6.49	0.50	5.80
P值		>0.05	<0.05	>0.05	<0.05	>0.05	<0.05

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