Stecher Frederik S, Olsen Jan-Aage, Stickney Ronald E, Wik Lars
National Competence Centre of Emergency Medicine, Institute for Experimental Medical Research, Ulleval University Hospital, 0027 Oslo, Norway.
Resuscitation. 2008 Dec;79(3):432-7. doi: 10.1016/j.resuscitation.2008.08.007.
There is a need to measure cardiopulmonary resuscitation (CPR) in order to document whether ambulance personnel follow CPR guidelines. Our goal was to do this using defibrillator technology based on changes in transthoracic impedance (TTI) produced by chest compressions and ventilations.
122 incidents of out-of-hospital cardiac arrest between May 2003 and February 2004 were analysed based on data recorded from defibrillators in Oslo EMS. New software was used to analyze chest compressions and ventilations based on changes in thoracic impedance between the defibrillator pads, as well as ECG and other event data.
In total, 25+/-14% (varying from 76% to 3%) of the time chest compressions were not performed on patients without spontaneous circulation (NFR=No Flow Ratio). When adjusting for time spent on analysis of ECG, pulse check and defibrillation, NFR was 20+/-13% (varying from 70% to 3%). Mean compressions delivered per minute was 87+/-16 and the compression rate during active compressions was 117+/-9min(-1). Individual variation was 31-117min(-1) (mean) and 95-144min(-1) (active periods). A mean of 14+/-3ventilations/min was recorded, varying from 8 to 26min(-1). Compared with the rest of the episode, the first 5min had a significantly higher proportion of time without chest compressions; 30+/-17% (p<0.001) and significantly lower mean compression and ventilation rates; 80+/-19min(-1) and 12+/-4min(-1), respectively (p<0.001 in both cases).
Core CPR values can be measured from TTI signals by using a standard defibrillator and new software. NFR was 25% (20% adjusted) with great rescuer variability.
为记录急救人员是否遵循心肺复苏指南，有必要对心肺复苏（CPR）进行测量。我们的目标是利用基于胸外按压和通气产生的经胸阻抗（TTI）变化的除颤器技术来实现这一目标。
基于奥斯陆紧急医疗服务（EMS）系统中除颤器记录的数据，对2003年5月至2004年2月期间122例院外心脏骤停事件进行了分析。使用新软件基于除颤器电极片之间的胸阻抗变化以及心电图和其他事件数据来分析胸外按压和通气情况。
总体而言，在无自主循环的患者中，胸外按压未实施的时间占25±14%（范围从76%至3%）（NFR = 无血流比率）。在对心电图分析、脉搏检查和除颤所花费的时间进行校正后，NFR为20±13%（范围从70%至3%）。每分钟平均按压次数为87±16次，有效按压期间的按压频率为117±9次/分钟。个体差异为31 - 117次/分钟（平均）和95 - 144次/分钟（活动期）。记录到的平均通气频率为14±3次/分钟，范围为8至26次/分钟。与事件的其余时段相比，最初5分钟内无胸外按压的时间比例显著更高；为30±17%（p<0.001），且平均按压和通气频率显著更低；分别为80±19次/分钟和12±4次/分钟（两种情况p均<0.001）。
通过使用标准除颤器和新软件，可以从TTI信号中测量核心心肺复苏值。NFR为25%（校正后为20%），施救者之间差异很大。
