收稿日期: 2024-10-31
网络出版日期: 2025-06-06
Neuro-monitoring and nursing management practice during the low perfusion period in emergency cardiac arrest patients
目的 针对心搏骤停患者自主循环恢复后脑损伤问题,基于适配标准原则建立并实践急诊心搏骤停患者低灌流期间神经系统监测与护理管理方案,为临床护士提供心肺复苏患者低灌注期间神经系统的管理指导。方法 本研究通过组建跨学科团队,基于美国心脏协会和国际复苏联络委员会指南,制订适合本院急诊心搏骤停患者低灌流期间神经系统监测与护理方案。试验组68例根据方案实施复苏;对照组采用传统心肺复苏流程。结果 两组年龄、性别、心搏骤停原因与结局的差异均无统计学意义,试验组存活患者的神经功能评价较对照组好(P=0.017);试验组自主循环恢复的患者呼气末二氧化碳和脑血氧饱和度指标的变化趋势与国内外研究一致,但由于样本量有限,两组差异无统计学意义。结论 急诊心搏骤停患者低灌流期间神经系统监测与护理方案,有助于改善心肺复苏后的神经功能预后,但实施过程中仍面临一定的操作难度与技术挑战。
王飒 , 闫丹萍 , 刘亚洁 , 周帅帅 , 王美玲 , 林高兴 , 许书荣 , 周光居 , 王钰炜 . 急诊心搏骤停患者低灌流期间神经系统监测与护理管理实践[J]. 中华急危重症护理杂志, 2025 , 6(6) : 713 -718 . DOI: 10.3761/j.issn.2096-7446.2025.06.015
Objective The study aims to establish a neuro-monitoring and nursing plan during the low perfusion period in emergency cardiac arrest patients based on appropriate use criteria,to address the problem of brain injury after autonomous circulation recovery. This plan provides guidance for clinical nurses on neurological management during low perfusion period in cardiopulmonary resuscitation patients. Methods This study established a multidisciplinary team to develop a neuro-monitoring and nursing plan for emergency cardiac arrest patients during the low perfusion period based on the AHA and ILCOR guidelines. A total of 68 patients in the experimental group were resuscitated according to the plan,while the control group followed the traditional cardiopulmonary resuscitation protocol. Results There was no statistically significant difference between the two groups in terms of patient age,gender,cause of cardiac arrest,and outcomes. The neurological function assessment in survivors of the experimental group was significantly better than that of the control group(P=0.017). In patients who achieved ROSC in the experimental group,the changes in end-tidal CO2 and cerebral oxygen saturation were consistent with domestic and foreign studies,but due to the limited sample size,there is no statistically significant difference between the two groups. Conclusion The neuro-monitoring and nursing plan during the low perfusion period in emergency cardiac arrest patients holds promise for improving neurological outcomes after cardiopulmonary resuscitation. However,there are operational complexities and technical challenges during its implementation.
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