心肺复苏:难以以适当的速度维持足够的按压深度

IF 1 4区 医学 Q3 EMERGENCY MEDICINE Signa Vitae Pub Date : 2023-01-01 DOI:10.22514/sv.2023.104
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引用次数: 0

摘要

在过去的50年里,心肺复苏(CPR)中推荐的胸部按压已经变得更快和更深,但是在更高的频率下保持深度按压可能是困难的。我们的研究旨在确定急诊科(ED)是否进行了充分的按压(适当深度和速度的胸部按压)。我们还研究了适当的压缩性能对自然循环恢复(ROSC)的影响。这项前瞻性观察研究是在两个城市学术医疗中心的急诊科进行的。我们纳入了2020年5月至11月期间在急诊科接受心肺复苏的心脏骤停成年患者(年龄≥18岁)。我们排除了与创伤相关的心脏骤停,除第一次外的反复骤停,以及未使用监护除颤器(ZOLL x系列)的患者。从监测除颤器装置中获得以下数据:按压深度、按压率、胸部按压分数、心肺复苏术时间、按压率、按压率、按压深度、按压率和按压深度、按压深度和按压率。我们的研究纳入了50例患者,从中获得并分析了441个胸部按压序列。平均压迫深度为6.48±0.87 cm,压迫率为117±5/min,压迫率为92.1±3.70%。随着压缩率的增加,深度减小,并且大多数压缩都是过深压缩。在441个压缩序列中,有97个(21.9%)观察到充分的压缩(以推荐的速率进行适当的深度)。死亡组深度以下和速率以下百分比高于ROSC组(9.7±15.2%比3.3±3.5%,p = 0.27; 2.7±2.6%比1.2±0.9%,p = 0.06)。即使由熟练的ED工作人员执行,总体胸按压比对推荐的按压率和按压深度的依从性也较低。
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Cardiopulmonary resuscitation: difficulty in maintaining sufficient compression depth at the appropriate rate
Over the last 50 years, the recommended chest compression for cardiopulmonary resuscitation (CPR) has become faster and deeper, but maintaining deep compressions may be difficult at higher rates. Our study aimed to determine whether adequate compression (chest compression at an appropriate depth and rate) is being performed in emergency departments (ED). We also investigated the effect of adequate compression performance on the return of spontaneous circulation (ROSC). This prospective observational study was conducted at the EDs of two urban academic medical centers. We included adult patients (age ≥18 years) with cardiac arrest who underwent CPR in the ED between May and November 2020. We excluded patients with cardiac arrest related to trauma, repeated arrest except the first, and those for whom a monitor-defibrillator (ZOLL X-series) was not used. The following data were obtained from the monitor-defibrillator devices: compression depth, rate, chest compression fraction, CPR time, and percentage of compressions at the recommended rate and, at the recommended depth, at over and below rates, and depth, and at the appropriate depth and rate. Our study included 50 patients, from whom 441 chest compression sequences were obtained and analyzed. The mean compression depth, rate, and fraction were 6.48 ± 0.87 cm, 117 ± 5/min, 92.1 ± 3.70%, respectively. As the compression rate increased, the depth decreased, and most compressions were over-depth. Adequate compression (appropriate depth at recommended rate) was observed in 97 of the 441 compression sequences (21.9%). Below-depth and below-rate percentages were higher in the deceased group than that in the ROSC group (9.7 ± 15.2% vs. 3.3 ± 3.5%, p = 0.27; 2.7 ± 2.6% vs. 1.2± 0.9%, p = 0.06). The global ratio of chest compression showed low compliance with the recommended rate and depth, even when performed by skilled ED staff.
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来源期刊
Signa Vitae
Signa Vitae 医学-急救医学
CiteScore
1.30
自引率
9.10%
发文量
0
审稿时长
3 months
期刊介绍: Signa Vitae is a completely open-access,peer-reviewed journal dedicate to deliver the leading edge research in anaesthesia, intensive care and emergency medicine to publics. The journal’s intention is to be practice-oriented, so we focus on the clinical practice and fundamental understanding of adult, pediatric and neonatal intensive care, as well as anesthesia and emergency medicine. Although Signa Vitae is primarily a clinical journal, we welcome submissions of basic science papers if the authors can demonstrate their clinical relevance. The Signa Vitae journal encourages scientists and academicians all around the world to share their original writings in the form of original research, review, mini-review, systematic review, short communication, case report, letter to the editor, commentary, rapid report, news and views, as well as meeting report. Full texts of all published articles, can be downloaded for free from our web site.
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