Investigation of the factors that enable the recovery of spontane circulation in patients with cardiopulmonary resuscitation

Objective: It aims to evaluate the factors affecting the return of spontaneous circulation (SDGD) of patients who undergo cardiopulmonary resuscitation (CPR) in the Emergency Department of Recep Tayyip Erdogan University Training and Research Hospital. Materials and Methods: This study was conducted by retrospectively examining the computer-based patient records of patients who were admitted to be arrested at Recep Tayyip Erdogan University Training and Research Hospital Emergency Service between 01.01.2018 and 31.12.2019 with the approval of the ethics committee (2020/25). Age, gender, admission time, admission vital values, arrest location, arrest rhythm, first airway, CPR duration, laboratory tests, comorbid diseases and outcome patterns were used in the study. Results: This study was conducted by retrospectively examining 309 cardiopulmonary arrest cases, 118 (%38,2) of whom were women and 191 (%61,8) were men. The average age of patients who underwent CPR was 80 (69-85) in women and 68 (59-77) in men. A statistically significant difference was observed between the mean age of the patients who underwent CPR by gender (p0,0001). The blood gas parameters pH, pCO2, pO2, SatO2, HCO3, BE and Lactate median values were significantly different in patients with spontaneous circulation compared to patients with no spontaneous circulation (p<0,05). Likewise, there was a statistically significant difference between the median values of Na+ and K+ among the biochemical parameters (p<0,05). ROSC rates of out-of-hospital cases were lower than in-hospital cases, and this difference was found to be statistically significant (p<0,05). There was a statistically significant difference between the rate of spontaneous circulation return of in-hospital intubations and the rates of out-of-hospital intubations (p=0,039). In patients whose respiratory system diseases were thought to be the cause of arrest, 40 (%42,6) people who were provided with spontaneous circulation and 55 (%25,6) who could not provide spontaneous circulation, the difference was statistically significant (p=0,029). While there was a diagnosis of Asthma-COPD in %17 of the patients with spontaneous circulation, this diagnosis was present in %7 of the patients whose spontaneous circulation was not achieved (p=0,0069). Likewise, %21,5 of the patients with spontaneous circulation had a diagnosis of CHF, while %12,1 of the patients who could not provide spontaneous circulation had this diagnosis and there was a statistically significant difference (p=0,0369).ix Conclusion: According to the multivariate regression analysis made with the data obtained as a result of this study, two indicators play a role in our prediction in the return of spontaneous circulation. These two markers are pH value and respiratory arrests. Accordingly, the reversibility of spontaneous circulation is 2,76 times more than the other arrest reasons due to respiratory system arrests. On the other hand, an increase of 0,1 in the pH value was found to increase the probability of returning spontaneous circulation 0,43 times. Keywords: Emergency Service, CPR, ROSC