Markstaller K, Eberle B, Dick W F
Klinik und Poliklinik für Anästhesiologie, Inselspital, Universität Bern, Bern, Schweiz.
Anaesthesist. 2004 Oct;53(10):927-36. doi: 10.1007/s00101-004-0749-2.
A decade after the onset of a discussion whether ventilation could be omitted from bystander basic life support (BLS) algorithms, the state of the evidence is reevaluated. Initial animal studies and a prospective randomized patient trial had suggested that omission of ventilation during the first minutes of lay cardiopulmonary resuscitation (CPR) did not impair patient outcomes. More recent studies demonstrate, however, that this may hold true only in very specific scenarios, and that the chest compression-only technique was never superior to standard BLS. Instead of calling basics of BLS training and practice into question, more and better training of lay persons and professionals appears mandatory, and targeted use of dispatcher-guided telephone CPR should be evaluated and, if it improves outcome, it should be encouraged. Future studies should focus much less on the omission but on the optimization of ventilation under the specific conditions of CPR.
关于旁观者基本生命支持（BLS）算法中是否可省略通气这一讨论开始十年后，对现有证据状况进行了重新评估。最初的动物研究和一项前瞻性随机患者试验表明，在非专业人员进行心肺复苏（CPR）的最初几分钟内省略通气不会影响患者预后。然而，最近的研究表明，这可能仅在非常特定的情况下才成立，而且仅胸外按压技术从未优于标准BLS。与其质疑BLS培训和实践的基础，对非专业人员和专业人员进行更多、更好的培训似乎是必不可少的，还应评估调度员指导下的电话CPR的针对性使用情况，若其能改善预后，则应予以鼓励。未来的研究应少关注通气的省略，而多关注在CPR特定条件下通气的优化。
