Bohn Andreas, Gude Philipp
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Münster, Münster, Germany.
Curr Opin Anaesthesiol. 2008 Apr;21(2):200-3. doi: 10.1097/ACO.0b013e3282f63f12.
Current cardiopulmonary resuscitation guidelines emphasize that providing high-quality basic life support is the single most important contribution to successful resuscitation. Efficiency of advanced cardiac life support depends on sufficient cardiopulmonary resuscitation performance leading to continuous bloodflow and oxygenation. Existing data show that the quality of cardiopulmonary resuscitation performance is poor. Feedback technologies claim to improve cardiopulmonary resuscitation quality by supporting rescuers in their efforts.
Rescuers regularly fail to achieve chest compressions at sufficient frequency and depth. Interruption of chest compression whilst the patient is in cardiac arrest results in reduced chances for successful defibrillation and survival. ECG interpretation in cardiac arrest challenges rescuers and results in nonindicated defibrillations. In several simulator studies and clinical trails cardiopulmonary resuscitation performance was improved by introducing feedback elements. It remains unclear, however, to what extent feedback is needed and useful.
Since effective basic life support is crucial for victims of cardiac arrest, recent findings that cardiopulmonary resuscitation quality provided by professionals fails to achieve recommended levels is not acceptable. Efforts need to be made in order to improve cardiopulmonary resuscitation quality and to support rescuers by real-time feedback. The technical elements of cardiopulmonary resuscitation feedback need to be carefully studied before being introduced into practice.
当前心肺复苏指南强调,提供高质量的基础生命支持是对成功复苏最为重要的单一贡献。高级心脏生命支持的效果取决于充分的心肺复苏操作,以实现持续的血流和氧合。现有数据表明,心肺复苏操作的质量较差。反馈技术宣称可通过协助救援人员来提高心肺复苏质量。
救援人员常常无法以足够的频率和深度进行胸外按压。患者心脏骤停期间胸外按压的中断会降低成功除颤和存活的几率。心脏骤停时的心电图解读对救援人员构成挑战,并导致不必要的除颤。在多项模拟研究和临床试验中,通过引入反馈元素,心肺复苏操作得到了改善。然而,尚不清楚需要何种程度的反馈以及反馈是否有用。
由于有效的基础生命支持对心脏骤停患者至关重要,近期关于专业人员提供的心肺复苏质量未达推荐水平的发现是不可接受的。需要做出努力以提高心肺复苏质量,并通过实时反馈为救援人员提供支持。在将心肺复苏反馈的技术元素引入实践之前,需要仔细研究。