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小型化机械胸外按压装置:心肺复苏的新选择。

Miniaturized mechanical chest compressor: a new option for cardiopulmonary resuscitation.

作者信息

Ristagno Giuseppe, Castillo Carlos, Tang Wanchun, Sun Shijie, Bisera Joe, Weil Max Harry

机构信息

Weil Institute of Critical Care Medicine, Rancho Mirage, CA 92270, United States.

出版信息

Resuscitation. 2008 Feb;76(2):191-7. doi: 10.1016/j.resuscitation.2007.07.004. Epub 2007 Aug 28.

Abstract

AIM OF STUDY

After cardiac arrest, uninterrupted chest compressions with restoration of myocardial blood flow facilitates restoration of spontaneous circulation. We recognized that this may best be accomplished with a mechanical device and especially so during transport. We therefore sought to develop a lightweight, portable chest compressor which may be carried on the belt or attached to the oxygen tank typically carried on the back of the first response rescuer. A miniaturized pneumatic chest compressor (MCC) weighing less than 2 kg was developed and compared with a currently marketed "Michigan Thumper", which weighed 19 kg. We hypothesized that the 2 kg, low profile, portable device will be as effective as the standard pneumatic Thumper for restoring circulation during CPR.

MATERIAL AND METHODS

Ventricular fibrillation was electrically induced in 10 domestic male pigs weighing 39+/-2 kg, and untreated for 5 min. Animals were then randomized to receive chest compressions with either the MCC or the Thumper. After 5 min of mechanical chest compression, defibrillation was attempted with a 150 J biphasic shock. Coronary perfusion pressure (CPP) and end tidal PCO(2) (EtPCO(2)) were measured by conventional techniques together with right carotid artery blood flow (CBF).

RESULTS

Four of five animals compressed with the Thumper and each animal compressed with the MCC were successfully resuscitated. No significant differences in CPP, EtPCO(2), CBF and post-resuscitation myocardial function were observed between groups. Resuscitated animals survived for more than 72 h without neurological impairment.

CONCLUSION

The low profile, 2 kg miniaturized chest compressor is as effective as the conventional Thumper in an experimental model of CPR.

摘要

研究目的

心脏骤停后,持续进行胸外按压并恢复心肌血流有助于自主循环的恢复。我们认识到,这最好通过机械设备来完成,尤其是在转运过程中。因此,我们试图开发一种轻便、便携的胸外按压装置,它可以系在腰带上,或者连接到通常由急救人员背在背上的氧气罐上。我们研制了一种重量不到2千克的小型气动胸外按压装置(MCC),并将其与目前市场上销售的重达19千克的“密歇根胸外按压器”进行比较。我们假设,这种2千克、外形小巧的便携式装置在心肺复苏期间恢复循环的效果与标准气动胸外按压器一样好。

材料与方法

对10头体重39±2千克的家养雄性猪进行电诱导室颤,不进行治疗,持续5分钟。然后将动物随机分为两组,分别使用MCC或胸外按压器进行胸外按压。进行5分钟机械胸外按压后,尝试用150焦耳双相电击除颤。采用传统技术测量冠状动脉灌注压(CPP)、呼气末二氧化碳分压(EtPCO₂)以及右颈动脉血流量(CBF)。

结果

使用胸外按压器按压的5只动物中有4只成功复苏,使用MCC按压的每只动物也都成功复苏。两组之间在CPP、EtPCO₂、CBF以及复苏后心肌功能方面未观察到显著差异。复苏后的动物存活超过72小时,且无神经功能损害。

结论

在心肺复苏实验模型中,这种2千克、外形小巧的小型胸外按压装置与传统胸外按压器效果相同。

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