Weil M H, Gazmuri R J
Department of Medicine, University of Health Sciences/The Chicago Medical School, Illinois.
Appl Cardiopulm Pathophysiol. 1991;4(2):97-102.
Reversal of cardiac arrest is contingent on rapid and effective restoration of myocardial blood flow. Thirty years have elapsed since closed-chest cardiopulmonary resuscitation (CPR) was introduced in clinical practice. Because of its technical simplicity and noninvasiveness, CPR was rapidly implemented and almost universally utilized for cardiac resuscitation. However, there is increasing concern about its value for cardiac resuscitation since the limited hemodynamic efficacy of precordial compression accounts for a disappointingly low success rate. More invasive interventions by which blood flow is restored such as open-chest cardiac massage or extracorporeal circulation are consistently more effective than conventional CPR. Experimentally, both methods restore systemic and myocardial perfusion to viable levels and thereby increase the likelihood of restoring spontaneous circulation even after prolonged cardiac arrest or failure of conventional CPR.
心脏骤停的逆转取决于心肌血流的快速有效恢复。自闭胸心肺复苏术（CPR）引入临床实践以来，三十年已经过去了。由于其技术简单且无创，CPR迅速得到实施并几乎普遍用于心脏复苏。然而，由于胸前按压有限的血流动力学效果导致令人失望的低成功率，人们对其心脏复苏价值的担忧日益增加。诸如开胸心脏按摩或体外循环等恢复血流的侵入性更强的干预措施始终比传统CPR更有效。在实验中，这两种方法都能将全身和心肌灌注恢复到可行水平，从而增加即使在长时间心脏骤停或传统CPR失败后恢复自主循环的可能性。
