Effect of preoxygenation before tracheal intubation on survival of patients with prehospital cardiac arrest

Wu Bing

doi:10.3969/j.issn.1672-8521.2023.04.003

Abstract：Objective:To explore the effect of preoxygenation before tracheal intubation on the survival of patients with prehospital cardiac arrest,and to provide reference for clinical treatment of patients with prehospital cardiac arrest.Methods:A total of 63 patients with pre-hospital cardiac arrest admitted to Xiamen Medical Emergency Center from October 2018 to May 2022 were prospectively selected as the research objects.They were divided into two groups randomly,including 31 cases in group A(tra-cheal intubation)and 32 cases in group B(tracheal intubation+airbag mask).Both groups were followed up for 6 months.The time of spontaneous circulation recovery,airway opening,respiratory recovery,heartbeat recovery and consciousness improve-ment,left ventricular ejection fraction(LVEF)and the ratio of early diastolic maximum peak velocity(E)/maximum peak ve-locity of late diastolic filling peak(A)were measured immediately after admission,at 1 h and 6 h after cardiopulmonary resusci-tation.The changes of pH(potential of hydrogen,pH),partial pressure of oxygen(PaO2),partial pressure of carbon dioxide in artery(PaCO2)and PaO2/fraction of inspiration O2(FiO2)were observed immediately after admission and 6 h after CPR,suc-cess rate of cerebral resuscitation and final survival rate were followed up for 6 months.Results:The recovery time of spontaneous circulation,airway opening,respiratory recovery,cardiac rhythm recovery and consciousness improvement in group B was shorter than that in group A(P＜0.05).Compared with the immediate admission,the LVEF and E/A ratio of group A and group B in-creased gradually at 1 h and 6 h after cardiopulmonary resuscitation,and the LVEF and E/A ratio of group B were higher than those of group A(P＜0.05).Immediately after admission,PaO2,PaO2/FiO2 and pH value of group A and group B increased at 6 h after cardiopulmonary resuscitation.PaCO2 decreased(P＜0.05).Before discharge,the proportion of CPC grade 1-2 in group B was higher than that in group A(x2=4.661,P＜0.05).Conclusions:Airbag mask combined with tracheal intubation can effec-tively improve the cardiac function and blood gas indexes of patients with pre-hospital cardiac arrest,and promote the recovery of vital signs.The success rate and survival rate of cardiopulmonary cerebral resuscitation are comparable to those of tracheal in-tubation.