The relationship between diastolic pressure of trauma patients after cardiopulmonary resuscitation (CPR) with their prognosis in the intensive care unit

Abstract

Determining predictors of patient outcomes after cardiac arrest is important for health system professionals. Some factors have been shown to be associated with good outcome and some with death or severe neurological impairment. The aim of this study is the evaluation of the relationship between diastolic pressure of trauma patients after cardiopulmonary resuscitation (CPR) with their prognosis in the intensive care unit. Materials and Methods: This study was a descriptive-analytical cross-sectional study. In this study, the target population was the traumatic patients hospitalized in the ICUs of Imam Reza Hospital, which suffered a cardiac arrest and CPR during the period of 2019-24. The sample size of 90 was calculated. The sampling method in this study was census. For each patient, their information was recorded. This information included age, gender, underlying diseases, basic testing at the intensive care unit, hospitalization period in intensive care unit, hospitalization period, patient hemodynamic parameters immediately after spontaneous circulation (ROSC) included SBP, DBP, MAP, CPR result, initial cardiac rhythm, number and duration of CPR, the intubation or non-intubation before CPR and the epinephrine rate prescribed. The consequence of patients' prognosis with GOS tools was also evaluated during discharge. The type of trauma and the intensity of the trauma were determined by the Injury Severity Score. Finally, the relationship between patients' blood pressure after the CPR and the prognosis of traumatic patients hospitalized in the intensive care unit of the Imam Reza Medical Educational Center. Results: In this study, the type of trauma in 84 cases (93.3%) of the studied subjects was multitrauma and in 6 cases (6.7%) was head trauma. The mean (standard deviation) of mean arterial pressure (MAP), systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the studied patients were 64.14 (±19.1), 52.88 (±17.8) and 87.40 (±23.8), respectively. The median (first and third quartile) duration of hospitalization in the intensive care unit and hospital was 6.0 (1.0-14.0) and 7.0 (1.0-15.0) days, respectively. The mean (SD) of CPR number and CPR duration (in minutes) in these patients were 2.27 (±0.7) and 26.04 (±9.7), respectively. Finally, 85 cases (94.4%) of the studied patients died and 5 cases (5.6%) recovered. Among all variables of basic tests and hemodynamic parameters, mean arterial pressure (MAP), systolic blood pressure (SBP) and diastolic blood pressure (DBP) variables were significantly higher in recovered patients than in deceased patients (P<0.001); On the other hand, other variables such as platelets, white and red blood cells, hematocrit, hemoglobin, PT and PTT, there was no statistically significant difference between the two groups of recovered and deceased patients (P<0.05). According to regression analysis, among hemodynamic parameters, mean arterial pressure (MAP) has a higher effect size than systolic blood pressure (SBP) and diastolic blood pressure (DBP).