A preliminary study of blood flow ultrasonography in carotid artery by unarmed and mechanical cardiopulmonary resuscitation
DOU Lian-feng1 FAN Guo-ai1 YIN Zhi-yong1 ZHANG Yan-zhen1 TIAN Fei2▲
1.Department of Emergency,Affiliated Hospital of Binzhou Medical College,Shandong Province,Binzhou 256603,China;
2.Department of Ultrasound,Affiliated Hospitalof Binzhou Medical College,Shandong Province,Binzhou 256603,China
Abstract：Objective To explore the characteristics and monitoring effect of blood flow ultrasonography in carotid artery during unarmed and mechanical cardiopulmonary resuscitation.Methods A total of 28 patients with cardiac arrest ad鄄mitted into our department of emergency from November 2015 to November 2016 were selected as research objects. They were evenly divided into unarmed cardiopulmonary resuscitation(CPR)group (n=14)and mechanical CPR group (n=14)in random.In the unarmed CPR group,unarmed chest compression for 30 minutes was used,while in the me鄄chanical CPR group,30-minute mechanical chest compression was adopted.The average of peak systolic velocity(PSV) in carotid artery and frequency of compression in each minute during the initial 5 minutes and the terminal 5 minutes were measured by Ultrasound Doppler technique.Results In the unarmed CPR group,the average PSV value in carotid artery during the initial 5 minutes was higher than that of the terminal 5 minutes with a statistical difference(P＜0.01). The achieved rate of compression frequency was also higher than that in the terminal 5 minutes(P＜0.05).In the me鄄chanical CPR group,the average PSV values in the initial 5 minutes,terminal 5 minutes,and achieved rate of compres鄄sion frequency were all higher than those in the unarmed CPR group with statistical differences(P＜0.01).The achieved rate of compression in the mechanical CPR was 100%.Conclusion Compared with unarmed CPR,the mechanical CPR can obtain a better carotid artery perfusion.Ultrasonography can realize the real-time feedback of compression frequen鄄cy and blood flow in carotid artery,and is used as a non-invasive CPR quality control.
Abella BS，Alvarado JP，Myklebust H，et al.Quality of cardiopulmonary resuscitation during in-hospital cardiacarrest[J]. JAMA，2005，293（3）：305-310.
[2]
Buck-Barrett I，Squire I.The use of basic life support skills by hospital staff：what skill should be taught?[J].Resuseitation，2004，60（1）：39-44.
[3]
Kleinman ME，Brennan EE，Goldberger ZD，et al.Adult basic life support and cardiopulmonary resuscitation quality：2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care[J].Circulation，2015，132（18 Suppl 2）：S414-S435.
Gamble G，Zorn J，Sanders G，et al.Estimation of arterial stiffness，compliance，and distensibility from M-mode ultrasound measurements of the common carotid artery[J]. Stroke，1994，25（1）：11-16.
[7]
Bluth EI，Starros AT，Marich KW，et al.Carotid duplex sonography：a multicenter recommendation for standardized imaging and Doppler criteria[J].Radiographics，1988，8（2）：487-506.
[8]
Yu AH，Cohen-Solal E，Raju BI，et al.An automated carotid pulse assessment approach using Doppler ultrasound[J].IEEE Trans Biomed Eng，2008，55（3）：1072-1081.
[9]
Larabee TM，Little CM，Raju BI，et al.A novel hands-free carotid ultrasound detects low-flow cardiac outputin a swine model of pulseless electrical activity arrest[J].Am J Emerg Med，2011，29（9）：1141-1146.
[10]
Adedipe AA，Fly DL，Schwitz SD，et al.Carotid Doppler blood flow measurement during cardiopulmonary resuscitation is feasible：a first in man study[J].Resuscitation，2015，96：121-125.
[11]
Scheei P，Ruge C，Schonig M.Flow velocity and flow volume measurements in the extracran ial carotid and vertebral arteries in healthy adults;reference data and the effects of age[J].Ultrasound Med Biol，2000，26（8）：1261-1266.
[13]
Aufderheide TP，Yannopoulos D，Lick CJ，et al.Implementing the 2005 American Heart Association Guidelines Improves Outcomes after Out-of-Hospital Cardiac Arrest[J]. Heart Rhythm，2010，7（10）：1357-1362.
[14]
Sutton RM，Maltese MR，Niles D，et al.Quantitative analysis of chest compression interruptions during in-hospital resuscitation of older children and adolescents[J].Resuscitation，2009，80（11）：1259-1263.
[16]
Zuercher M，Hilwig RW，Ranger-Moore J，et al.Leaning during chest compressions impairs cardiac output and left ventricular myocardialblood flow in pigletcardiac arrest[J]. Crit Care Med，2010，38（4）：1141-1146.
Wang CH，Huang CH，Chang WT，et al.Monitoring of serum lactate level during cardiopulmonary resuscitation in adult in-hospital cardiac arrest[J].Critical Care，2015，19（1）：1-9.
[20]
Smekal D，Johansson J，Huzevka T，et al.No difference in autopsy detected injuries in cardiac arrest patients treated with mamual chest compressions compared with mechanical compression with the LUCAS device-a pilot study[J]. Resuscitation，2009，80（8）：1104-1107.
京公网安备 11010502046607号