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新型自动机械按压与主动减压复苏设备LUCAS的评估

Evaluation of LUCAS, a new device for automatic mechanical compression and active decompression resuscitation.

作者信息

Steen Stig, Liao Qiuming, Pierre Leif, Paskevicius Audrius, Sjöberg Trygve

机构信息

Department of Cardiothoracic Surgery, Heart-Lung Division, University Hospital of Lund, Sweden.

出版信息

Resuscitation. 2002 Dec;55(3):285-99. doi: 10.1016/s0300-9572(02)00271-x.

Abstract

LUCAS is a new gas-driven CPR device providing automatic chest compression and active decompression. In an artificial thorax model, superior pressure and flow were obtained with LUCAS compared with manual CPR. In a randomized study on pigs with induced ventricular fibrillation significantly higher cardiac output, carotid artery blood flow, end-tidal CO(2), intrathoracic decompression-phase aortic- and coronary perfusion pressures were obtained with LUCAS-CPR (83% ROSC) compared to manual CPR (0% ROSC). In normothermic fibrillating pigs, the ROSC rate was 100% after 15 min and 38% after 60 min of LUCAS-CPR (no drug treatment). The ROSC rate increased to 75% if surface cooling to 34 degrees C was applied during the first 30 min of the 1-h resuscitation period. Experience with the first 20 patients has shown that LUCAS is light (6.5 kg), easy to handle, quick to apply (10-20 s), maintains a correct position, and works optimally during transport both on stretchers and in ambulances. In one hospital patient with a witnessed asystole where manual CPR failed, LUCAS-CPR achieved ROSC within 3 min. One year later the patient's mental capacity was fully intact. To conclude, LUCAS-CPR gives significantly better circulation during ventricular fibrillation than manual CPR.

摘要

LUCAS是一种新型的气体驱动心肺复苏设备,可提供自动胸外按压和主动减压功能。在人工胸廓模型中,与徒手心肺复苏相比,LUCAS能产生更高的压力和血流。在一项针对诱发心室颤动猪的随机研究中,与徒手心肺复苏(自主循环恢复率为0%)相比,LUCAS心肺复苏(自主循环恢复率为83%)能显著提高心输出量、颈动脉血流量、呼气末二氧化碳分压、胸内减压期主动脉和冠状动脉灌注压。在体温正常的颤动猪中,LUCAS心肺复苏(未进行药物治疗)15分钟后的自主循环恢复率为100%,60分钟后的自主循环恢复率为38%。如果在1小时复苏期的前30分钟进行体表降温至34摄氏度,自主循环恢复率可提高到75%。对最初20例患者的使用经验表明,LUCAS重量轻(6.5千克)、易于操作、应用迅速(10 - 20秒)、能保持正确位置,并且在担架和救护车上转运过程中均能最佳运行。在一名医院患者出现目击心搏停止且徒手心肺复苏失败的情况下,LUCAS心肺复苏在3分钟内实现了自主循环恢复。一年后,该患者的心智能力完全正常。总之,在心室颤动期间,LUCAS心肺复苏比徒手心肺复苏能显著改善循环。

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