Practical Geriatrics ›› 2021, Vol. 35 ›› Issue (7): 673-675.doi: 10.3969/j.issn.1003-9198.2021.07.003

Previous Articles     Next Articles

Value of early transcranial color-coded duplex sonography and APACHE Ⅱ score in evaluating the cerebral functional resuscitation in elderly patients receiving cardiopulmonary resuscitation

GUO Hui, QI Hui-jun, LYU Chang, LI Hong-ling, JIA Yang-juan, LI Jian-guo   

  1. Department of Emergency, Hebei Provincial People’s Hospital, Shijiazhuang 050051, China
  • Received:2020-07-04 Online:2021-07-20 Published:2021-08-02

Abstract: Objective To explore the clinical application value of early transcranial color-coded duplex sonography (TCCD) and acute physiology and chronic health evaluation (APACHE Ⅱ) score to evaluate the cerebral functional recovery after cardiopulmonary resuscitation. Methods A total of 70 patients with cardiac arrest who were successfully rescued by cardiopulmonary resuscitation from February 2017 to February 2019 in our hospital were enrolled in this study, and their clinical data were analyzed retrospectively. The patients were divided into observation group (30 patients with good prognosis) and control group (40 patients with poor prognosis) according to cerebral performance category (CPC). The cerebral blood flow was measured by TCCD, and APACHE Ⅱ score was calculated 24 hours after operation. The value of TCCD and APACHE Ⅱ score in evaluting the prognosis of cerebral functional recovery after cardiopulmonary resuscitation was analyzed. Results Compared with the control group, the end diastolic velocity (VD), peak systolic velocity (VS) and average peak velocity (VM) of the observation group increased significantly within 24 hours; The pulsation index and APACHE Ⅱ score of the middle cerebral artery in the observation group decreased significantly, with significant difference (P<0.05). The receiver operating characteristic (ROC) curves of cerebral blood flow and APACHE Ⅱ score were drawn to predict the prognosis of cerebral function. The results showed that the area under the cerebral blood flow curve and the best critical value was 0.725, 5.661, with a sensitivity and specificity of 66.0% and 78.5%, and the area under APACHE Ⅱ score curve and the best critical value was 0.846, 19.43, with a sensitivity and specificity of 78.6% and 79.6%, respectively. Conclusions In the early stage of cardiopulmonary resuscitation, the cerebral blood flow will increase and APACHE Ⅱ score will decrease significantly, which are associated with the prognosis of cerebral functional resuscitation. Monitoring the above indicators is conducive to clinical evaluation of patients’ condition.

Key words: cardiopulmonary resuscitation, transcranial color-coded duplex sonography, acute physiology and chronic health evaluation Ⅱ, cerebral blood flow, prognosis, aged

CLC Number: