Clinical efficacy and mechanism of epinephrine combined with low-dose ulinastatin in cardiopulmonary resuscitation

Chen Yingqiu; Xu Sunzhen

doi:10.3760/cma.j.issn.1673-4777.2015.03.012

Abstract：Objective To explore the clinical efficacy and mechanism of epinephrine combined with ulinastatin in cardiopulmonary resuscitation.Methods According to a stratified randomization method,82 cardiopulmonary arrest patients were divided into the observation group (n =45) and the control group (n =37).The control group was treated with intravenous injection of epinephrine (1.0 mg) + naloxone (2.0 mg) during the early stage cardiopulmonary resuscitation.The observation group was treated with intravenous injection of low dose of ulinastatin (100 000 IU) on the basis of the control group.Resuscitation effect,survival rate,laboratory indicators and the incidence of MODS for both groups were observed.Results The restoration of spontaneous circulation of the observation group and the control group were 77.8％ (35/45) and 54.1％ (20/37),respectively; the restoration of spontaneous breathing of the observation group and the control group were 57.8％ (26/45) and 29.7％ (11/37),respectively;there was significant difference between the two groups (P ＜ 0.05).The observation group was significantly better than the control group in terns of GCS score,heart rate,24 h survival rate and discharge survival rate [GCS scores:(7.9 ± 1.3) scores vs (5.5 ± 1.6) scores,heart rate:(108 ± 14) times per min vs (144 ± 11) times per min,(102 ± 14)times per min vs (128 ± 13)times per min,24 h survival rate:71.1％ (32/45) vs 45.9％ (17/37),discharge survival rate:62.2％ (28/37) vs 37.8％ (14/45)],there was significant difference between two groups (P ＜ 0.05).The observation group was significantly lower than the control group regarding the levels of albumin,lactic acid,tumor necrosis factor-α and interlenkin-6; there was significant difference between the two groups (P ＜ 0.05).The incidence of MODS of the observation group and the control group was 17.8％ (5/28) and 42.9％ (6/14),respectively; 28 d survival rate of the observation group and the control group was 71.4％ (20/28)and 50.0％ (7/14),respectively; there was significant difference between the two groups (P ＜ 0.05).The observation group was significantly better than the control group regarding the involving organs of MODS and APACHE score (P ＜ 0.05).Conclusions Epinephrine combined with low-dose ulinastatin can significantly improve the success rate of CPR,reduce the incidence of MODS and the levels of inflammatory cytokine.