Department of Emergency Medicine, Chonnam National University Hospital, 671 Jebongno, Donggu Gwangju 501-757, South Korea.
Emerg Med J. 2010 Jan;27(1):8-12. doi: 10.1136/emj.2008.070060.
The present study was undertaken to determine whether sustained manual abdominal compression (SMAC) using left paramedian compression technique can improve coronary perfusion pressure (CPP) during cardiopulmonary resuscitation (CPR) and resuscitation outcomes without causing liver laceration.
Ventricular fibrillation was induced in 14 pigs, and circulatory arrest was maintained for 6 min. Animals were resuscitated either by standard CPR (control group) or by standard CPR with SMAC (SMAC-CPR group).
Mean blood pressure, aortic diastolic pressure and right atrial diastolic pressure in the SMAC-CPR group were significantly greater than in the control group throughout simulated basic life support. However, since the increases in aortic and right atrial diastolic pressures were similar, no significant intergroup difference was found in terms of CPP. Return of spontaneous circulation (ROSC) was attained in four of seven animals in the control group and in six of seven animals in the SMAC-CPR group (p = 0.55). Three animals in the control group and four in the SMAC-CPR group survived 24 h after ROSC (p = 1.00). Two of the seven animals in the SMAC-CPR group had a ruptured liver, but no such injury occurred in the control group.
SMAC using left paramedian compression technique failed to improve CPP during CPR and resuscitation outcomes. Furthermore, this method could not avoid liver laceration.
本研究旨在确定使用左侧旁正中压迫技术的持续手动腹部压迫（SMAC）是否可以在心肺复苏（CPR）期间提高冠状动脉灌注压（CPP）并改善复苏结果，而不会导致肝脏破裂。
在 14 只猪中诱导心室颤动，并维持循环骤停 6 分钟。动物通过标准 CPR（对照组）或标准 CPR 加 SMAC（SMAC-CPR 组）进行复苏。
在模拟基本生命支持期间，SMAC-CPR 组的平均血压、主动脉舒张压和右心房舒张压均明显大于对照组。然而，由于主动脉和右心房舒张压的增加相似，CPP 无显著组间差异。在对照组中，有 4 只/7 只动物恢复自主循环（ROSC），而在 SMAC-CPR 组中，有 6 只/7 只动物恢复自主循环（p=0.55）。在对照组中有 3 只动物/7 只动物和在 SMAC-CPR 组中有 4 只动物/7 只动物在 ROSC 后 24 小时存活（p=1.00）。在 SMAC-CPR 组的 7 只动物中有 2 只发生了肝脏破裂，但在对照组中没有发生这种损伤。
使用左侧旁正中压迫技术的 SMAC 未能提高 CPR 期间的 CPP 和复苏结果。此外，这种方法不能避免肝脏破裂。
