呼气末二氧化碳分压在心肺复苏过程中的研究进展

doi:10.3969/j.issn.1002-1949.2019.01.019

摘要
图/表
参考文献(55)
相关文章 (15)

全文: PDF (751 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要心肺复苏（CPR）是抢救心脏骤停（CA）的重要方法，敏感的监测方法对提高CPR质量具有指导意义。而呼气末二氧化碳分压（PET CO2）可以较敏感地反映出机体CO2的产量、心排量、肺通气/血流比值等变化，是高质量CPR过程中不可缺少的监测指标。本文阐述PETCO2在CPR过程中每个环节的研究情况，为科学指导CPR过程提供依据，提高CPR成功率。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	邓颖
	胡光荣
	孙辉

关键词 ：呼气末二氧化碳分压（PETCO2）, 心肺复苏（CPR）, 心脏骤停（CA）

基金资助:国家卫生和计划生育委员会公益性行业科研专项项目（2015SQ00050）

通讯作者: 胡光荣（1983-），男，硕士，主治医师，E-mail:huguangronglj@163.com。

作者简介: 邓颖（1967-），女，博士，主任医师，硕士生导师，急诊医学科主任，E-mail:ldlrrr@163.com。

引用本文:

邓颖，胡光荣，孙辉. 呼气末二氧化碳分压在心肺复苏过程中的研究进展[J]. 中国急救医学, 2019, 39(1): 93-98.
Deng Ying, Hu Guang-rong, Sun Hui. Research progress of end-tidal carbon dioxide pressure in cardiopulmonary resuscitation. Chinese Journal of Critical Care Medicine, 2019, 39(1): 93-98.

链接本文:

http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.01.019 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I1/93

［1］ReaTD, Eisenberg MS, Becker LJ, et al. Temporal trends in sudden cardiac arrest: A 25-year emergency medical services perspective［J］. Circulation, 2003, 107(22): 2780-2785.  ［2］Lavery GG, McCloskey BV. The difficult airway in adult critical care［J］. Crit Care Med, 2008, 36(7): 2163-2173.  ［3］Geri G, Mongardon N, Daviaud F, et al. Neurological consequences of cardiac arrest: where do we stand［J］. Ann Fr Anesth Reanim, 2014, 33(2): 98-101. ［4］Deakin CD, Nolan JP, Soar J, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 4.Adult advanced life support［J］. Resuscitation, 2010, 81(10): 1305-1352.  ［5］Kalenda Z. The capnogram as a guide to the efficacy of cardiac massage［J］. Resuscitation, 1978, 6(4): 259-263. ［6］Grmec S, Lah K, Tusek-Bunc K. Difference in end-tidal CO2 between asphyxia cardiac arrest and ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest in the prehospital setting［J］. Crit Care, 2003, 7(6): R139-144.  ［7］Grmec S, Kupnik D. Does the Mainz Emergency Evaluation Scoring (MEES) in Combination with capnometry (MEESc) help in the prognosis of outcome from cardiopulmonary resuscitation in a prehospital setting ［J］. Resuscitation, 2003, 58(1): 89-96.  ［8］Kolar M, Krizmaric M, Klemen P, et al. Partial pressure of end-tidal carbon dioxide successful predicts cardiopulmonary resuscitation in the field: a prospective observational study［J］. Crit Care, 2008,12(5): R115. ［9］Pernat A, Weil MH, Sun SJ, et al. Stroke volumes and end-tidal carbon dioxide generated by precordial compression during ventricular fibrillation［J］. Crit Care Med, 2003, 31(6): 1819-1823. ［10］何颜霞，胡皓夫. 心肺复苏后内环境的变化及治疗［J］. 实用儿科临床杂志， 2006， 21(6): 323-325 . ［11］European Resuscitation Council. Part 3: adult basic life support［J］. Circulation, 2000, 46(1-3): 29-71. ［12］Kleinman ME, Brennan EE, Goldberger ZD, et al. Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality:2015AHA Guidelines Update for CPR and Emergency Cardiovascular Care［J］. Circulation, 2015,132(18 Suppl 2): S414-435. ［13］Ditchey RV, Winkler JV, Rhodes CA. Relative lack of coronary blood flow during closed-chest resuscitation in dogs［J］. Circulation, 1982, 66(2): 297-302. ［14］Qvigstad E, Kramer-Johansen J, Tomte O, et al. Clinical pilot study of different Hand positions during manual chest compressions monitored with capnography［J］. Resuscitation, 2013, 84(9): 1203-1207.  ［15］Ward KR, Menegazzi JJ, Zelenak RR, et al. A comparison of chest compressions Between mechanical and manual CPR by monitoring end-tidal PCO2 during human cardiac arrest［J］. Ann Emerg Med, 1993, 22(4): 669-674. ［16］刘景峰，段美丽，苏伟，等. 呼气末二氧化碳分压评估两种心肺复苏方式的临床效果［J］. 临床和实验医学杂志， 2013， 12 (2): 103-104. ［17］Sheak KR, Wiebe DJ, Leary M, et al. Quantitative relationship between end-tidal Carbon dioxide and CPR quality during both in-hospital and out-of-hospital cardiac arrest［J］. Resuscitation, 2015, 89:149-154.  ［18］Touma O, Davies M. The prognostic value of end tidal carbondioxide during cardiac arrest: a systematic review［J］. Resuscitation,〖JP〗 2013, 84(11): 1470-1479.  ［19］Miyata K, Mikami T, Asai Y, et al. Subarachnoid hemorrhage after resuscitation from out-of-hospital cardiac arrest［J］. J Stroke Cerebrovasc Dis, 2014, 23(3): 446-452. ［20］Hinduja A, Gupta H, Yang JD, et al. Hypoxic ischemic brain injury following in hospital cardiac arrest-Lessons from autopsy［J］. J Forensic Leg Med, 2014, 23: 84-86. ［21］Vittoria Matassini M, Krahn AD, Gardner M, et al. Evolution of clinical diagnosis in patients presenting with unexplained cardiac arrest or syncope due to polymorphic ventricular tachycardia［J］. Heart Rhythm, 2014, 11(2): 274-281. ［22］冉启华，余志豪，杨应萍，等. 呼气末二氧化碳在口腔手术中监测的意义［J］. 贵州医药， 2001， 25（1）: 30-31. ［23］Vukmir RB, Heller MB, Stein KL. Confirmation of endotracheal tube placement: a miniaturized infrared qualitative CO2 detector［J］. Ann Emerg Med, 1991, 20(7): 726-729.  ［24］Grmec S. Comparison of three different methods to confirm tracheal Tube placement in emergency intubation［J］. Intensive Care Med, 2002, 28(6): 701-704.  ［25］Silvestri S, Ralls GA, Krauss B, et al. The effectiveness of out-of-hospital use of continuous end-tidal carbon dioxide 〖JP2〗monitoring on the rate of unrecognized misplaced intubation within〖JP〗 a regional emergency medical services system［J］ .Ann Emerg Med, 2005, 45(5): 497-503.  ［26］左立旻，李茂霞，贺月秋，等. 呼气末二氧化碳检测在儿科气管插管位置判定中的临床应用［J］. 中国现代医生， 2018， 56(5): 7-9. ［27］Aufderheide TP, Sigurdsson G, Pirrallo RG, etal. Hyperventilation-induced hypotension during cardiopulmonary resuscitation［J］. Circulation, 2004, 109(16): 1960-1965. ［28］邢峰，李茂源. 呼气末二氧化碳分压判断气管导管位置的改进［J］. 中华麻醉学杂志， 2003， 23(7): 555-556. ［29］Cantineau JP, Merckx P, Lambert Y, et al. Effect of epinephrine on end-tidal carbon dioxide pressure during prehospital cardiopu〖JP〗lmonary resuscitation［J］. Am J Emerg Med, 1994, 12(3): 267-270. ［30］卢俊光，何明丰，张英俭. 参附注射液在心肺复苏过程中作用及对呼气末二氧化碳分压的影响［J］. 现代中西医结合杂志， 2015， 24（9）: 924-926， 935. ［31］Lah K, Krizmaric M, Grmec S. The dynamic pattern of end-tidal carbon dioxide during cardiopulmonary resuscitation: difference between asphyxial cardiac arrest and ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest［J］. Crit Care, 2011, 15(1): R13. ［32］高勇，沈华，刘雄华. 碳酸氢钠中心静脉注射后呼气末二氧化碳分压的变化与心排血量及血红蛋白的关系［J］. 中华麻醉学杂志， 1999， 19(4): 230-232. ［33］Wang H, Sha X, Zhang S, et al. Predictive value of partial pressure of end-tidal carbon dioxide on the effect of active abdominal compression-decompression cardiopulmonary resuscitation and serum S100B protein on cerebral function［J］. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 2018, 30(2): 117-122. ［34］Wang D, Feng X, Han Y. Interposed abdominal pulling-pressing cardiopulmonary resuscitation improve the resuscitation effect for patients with cardiac arrest［J］. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 2018, 30(5): 466-470. ［35］汪宏伟，张思森，沙鑫，等. PETCO2在腹部提压心肺复苏急救效果评估中的临床价值分析:附92例报告［J］. 中华卫生应急电子杂志， 2017， 3(2): 107-112. ［36］Heradstveit BE, Sunde K, Sunde GA, et al. Factors complicating interpretation of capnography during advanced life support in cardiac arrest-a clinical retrospective study in 575 patients［J］. Resuscitation, 2012, 83(7): 813-818.  ［37］Sun F, Li C, Fu Y, et al. Predictive value of continuous monitoring end-tidal carbon dioxide partial pressure on in-hospital resuscitation outcome: secondary analysis of the data from a multicenter observational study［J］. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 2018, 30(1): 29-33. ［38］张建中. 呼气末二氧化碳分压监测在院前呼吸支持中的应用［J］. 中国急救医学， 2015， 35(12): 1151-1152. ［39］Kolar M, Krizmaric M, Klemen P, et al. Partial pressure of end-tidal carbon dioxide successful predicts cardiopulmonary resuscitation in the field: a prospective observational study［J］. Crit Care, 2008, 12(5): R115. ［40］Levine RL, Wayne MA, Miller CC. End-tidal carbon dioxide and outcome of out-of-hospital cardiac arrest［J］. N Engl J Med, 1997, 337(5): 301-306.  ［41］Morrison LJ, Neumar RW, Zimmerman JL, et al. Strategies for improving survival after in-hospital cardiac arrest in the United States:2013 consensus recommendations:a consensus statement from the American Heart Association［J］. Circulation, 2013, 127(14): 1538-1563. ［42］Pearce AK, Davis DP, Minokadeh A, et al. Initial end-tidal carbon dioxide as a prognostic indicator for inpatient PEA arrest［J］. Resuscitation, 2015, 92: 77-81. ［43］Neumar RW, Otto CW, Link MS, et al. Part 8: adult advanced cardiovascular life support:2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care［J］. Circulation, 2010, 122(18 Suppl 3): S729-767. ［44］刘斌，寿松涛，李晨. 平均呼气末二氧化碳分压评估院内心搏骤停患者心肺复苏质量和预后的临床价值［J］. 中华临床医师杂志(电子版)， 2017， 11(2): 222-225. ［45］吴莹，濮娜，张彩萍. 气管插管不同时机对急诊心肺复苏患者成功率的影响［J］. 医学综述， 2016， 22(14): 2859-2861. ［46］赵静静. 呼气末二氧化碳分压监测在心肺复苏中的应用进展［J］. 中国急救医学， 2011， 31(4): 358-361. ［47］Okamoto H, Hoka S, Kawasaki T, et al. Changes in end-tidal carbon dioxide tension following sodium bicarbonate administration: correlation with cardiac output and haemoglobin concentration［J］. Acta Anaesthesiol Scand, 1995, 39(1): 79-84. ［48］刘斌. 呼气末二氧化碳分压监测对心脏骤停患者心肺复苏质量和预后的评估价值［D］. 天津医科大学， 2016: 1-69. ［49］贾平，何平，廖天芬. 气管导管门齿外长度对二氧化碳分压的影响［J］. 中华护理杂志， 2005， 40(2): 148-149. ［50］杨爱祥，方强，杨静，等.心电监护对心脏骤停时胸外按压复苏效果的分析［J］. 中国急救医学， 2011， 31(5): 454-456. ［51］胡光荣，王天群，贾广生，等. CO中毒动脉血氧饱和度与脉搏血氧饱和度的对比研究［J］. 哈尔滨医科大学学报， 2013， 62（5）: 469-470. ［52］叶健晓，田昕，朱虹. 心肺复苏期间心电监测对判断自主循环恢复的准确性分析［J］. 中国乡村医药， 2014， 21（17）: 12-13. ［53］刘书雁，冯锡烜，江倩华. 有创动脉血压监测在心肺复苏中应用研究［J］. 中国现代药物应用， 2017， 11(12): 64-66. ［54］李志，林健球. Swan-Ganz 飘浮导管监测血流动力学指标在心肺复苏中指导价值［J］. 临床肺科杂志， 2016， 21（3）: 396-399. ［55］Macedo AC, Martins LC, Paschoal IA, et al. PETCO2, VCO2 and CorPP Values in the Successful Prediction of the Return of Spontaneous Circulation: An Experimental Study on Unassisted Induced Cardiopulmonary Arrest［J］. Braz J Cardiovasc Surg, 2016, 31(6): 468-473.