Abstract:【Objective】To explore the correlation between mild hypothermia treatment at different temperatures and pulmonary infection in patients with cardiac arrest and recovery of cardiac rhythm through cardiopulmonary resuscitation. 【Methods】Seventy-two patients after cardiopulmonary resuscitation in our hospital were randomly divided into three groups: group A, group B and group C, with 24 cases in each group. Group A was treated with non-hypothermia, group B with 36 ℃ hypothermia and group C with 33 ℃ hypothermia. The survival rates at 2 weeks after treatment and at the time of hospital discharge in the three groups were compared, and the clinical pulmonary infection score (CPIS), sputum culture positive rate, sputum culture positive pathogenic bacteria spectrum, oxygen and index and infection indexes [Creactive protein (CRP) and procalcitonin (PCT)] on treatment 3 d and treatment 7 d were compared among the three groups. 【Results】There was no significant difference in the survival rate between the three groups after 14 days of treatment and at the time of discharge (P>0.05). The CPIS score of group C on 3 d and 7 d of treatment was lower than that of group A and group B (P<0.05). There was no significant difference in the positive rate of sputum culture among the three groups on 3 d of treatment (P>0.05). The positive rate of sputum culture on 7 d of treatment in group C was lower than that in group A and group B (P<0.05). There was no significant difference in sputum culture positive pathogenic bacteria spectrum between the three groups on treatment day 3 and treatment day 7 (P>0.05). On treatment 3 d and 7 d, the oxygen and index of group C were higher than those of group A and group B, and the levels of CRP and PCT were lower than those of group A and group B (P<0.05). 【Conclusion】The mild temperature control, which is at 33 ℃ hypothermia treatment after cardiopulmonary resuscitation, can reduce pulmonary infection, reduce the positive rate of sputum culture, increase oxygen and index, and improve the levels of CRP and PCT.
刘延玲, 巨芳萍. 心肺复苏后不同温度的亚低温治疗与肺部感染的相关性研究[J]. 医学临床研究, 2022, 39(2): 180-182.
LIU Yan-ling, JU Fang-ping. Correlation between Temperature of Hypothermia Treatment and Pulmonary Infection after Cardiopulmonary Resuscitation. JOURNAL OF CLINICAL RESEARCH, 2022, 39(2): 180-182.
[1] NAGAO K, KIKUSHIMA K, WATANABE K, et al. Early induction of hypothermia during cardiac arrest improves neurological outcomes in patients with out-of-hospital cardiac arrest who undergo emergency cardiopulmonary bypass and percutaneous coronary intervention[J].Circ J,2010, 74(1): 77-85.
[2] 王淦楠. 心搏骤停后昏迷患者神经功能预后评估的研究进展 [J].中华急诊医学杂志, 2016, 5(25): 687-690.
[3] BERMARD S A, GRAY T W, BUIST M D, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia [J].N Engl J Med, 2002, 346(8): 557-563.
[4] 邹洋洋. 血管内降温治疗对复苏后综合征的保护作用及机制研究 [J].中华危重病急救医学, 2018, 9(30): 888-893.
[5] 心脏骤停后目标温度管理共识专家组. 心脏骤停后目标温度管理专家共识 [J].中华急诊医学杂志, 2016, 8(25): 1000-1006.
[6] YOUNG M N, HOLLENBECK R D, POLLOCK J S,et al. Higher achieved mean arterial pressure during therapeutic hypothermia is not associated with neurologically intact survival following cardiac arrest[J].Resuscitation,2015, 88: 158-164.
[7] NIELSEN N, WETTERSLEV J, CRONBERG T, et al. Targeted temperature management at 33 ℃ versus 36 ℃ after cardiac arrest [J].N Engl J Med,2013, 369(23): 2197-2206.
[8] KIM J J, YANG H J, LIM Y S, et al. Effectiveness of each target body temperature during therapeutic hypothermia after cardiac arrest [J].Am J Emerg Med,2011, 29(2): 148-154.
[9] TASAN E, JESINGER M E, CHAMIGO R J, et al. Early Prognosticators for Induction of Therapeutic Hypothermia Following Cardiac Arrest [J].Ther Hypothermia Temp Manag,2016, 6(3): 122-129.
[10] YOUNG M N, HOLLENBECK R D, POLLOCK J S, et al. Effectiveness of mild therapeutic hypothermia following cardiac arrest in adult patients with congenital heart disease [J].Am J Cardiol,2014, 114(1): 128-130.