University of Arizona College of Medicine's Sarver Heart Center, Tucson, AZ, USA.
Resuscitation. 2010 May;81(5):585-90. doi: 10.1016/j.resuscitation.2010.01.009. Epub 2010 Feb 20.
This study was designed to compare 24-h survival rates and neurological function of swine in cardiac arrest treated with one of three forms of simulated basic life support CPR.
Thirty swine were randomized equally among three experimental groups to receive either 30:2 CPR with an unobstructed endotracheal tube (ET) or continuous chest compression (CCC) CPR with an unobstructed ET or CCC CPR with a collapsable rubber sleeve on the ET allowing air outflow but completely restricting air inflow. The swine were anesthetized but not paralyzed. Two min of untreated VF was followed by 9 min of simulated single rescuer bystander CPR. In the 30:2 CPR group, each set of 30 chest compressions was followed by a 15-s pause to simulate the realistic duration of interrupted chest compressions required for a single rescuer to deliver 2 mouth-to-mouth ventilations. The other two groups were provided continuous chest compressions (CCC) without assisted ventilations. At 11 min post-arrest a biphasic defibrillation shock (150 J) was administered followed by a period of advanced cardiac life support.
In the 30:2 group, 8 of 10 animals had good neurological function at 24-h post-resuscitation. In the CCC open airway group, 10 of 10, and in the CCC inspiratory obstructed group, 9 of 10. The number of shocks (P<0.05) and epinephrine doses (P<0.05) required for ROSC was greater in the 30:2 CPR group than in the other two groups.
There were no differences in 24-h survival with good neurological function among these three different CPR protocols.
本研究旨在比较三种模拟基础生命支持 CPR 中,猪心搏骤停后 24 小时生存率和神经功能。
30 头猪随机分为三组,分别接受通畅气管插管 30:2 心肺复苏(CPR)、通畅气管插管持续胸部按压(CCC)CPR 或气管插管上套可折叠橡胶套以允许空气流出但完全限制空气流入的 CCC CPR。猪被麻醉但未麻痹。未经治疗的室颤(VF)持续 2 分钟,然后进行 9 分钟的模拟单人旁观者 CPR。在 30:2 CPR 组中,每 30 次胸部按压后停顿 15 秒,以模拟单人复苏者进行 2 次口对口通气所需的中断胸部按压的实际持续时间。其他两组提供连续胸部按压(CCC)而不进行辅助通气。在心脏骤停后 11 分钟,给予双相除颤电击(150J),然后进行高级心脏生命支持。
在 30:2 组中,10 头动物中有 8 头在复苏后 24 小时具有良好的神经功能。在 CCC 开放气道组中,10 头全部,在 CCC 吸气阻塞组中,10 头中有 9 头。30:2 CPR 组需要的电击次数(P<0.05)和肾上腺素剂量(P<0.05)均高于其他两组。
这三种不同的 CPR 方案在 24 小时生存率和良好的神经功能方面没有差异。