Concord Healthcare Strategies, Concord, Massachusetts, USA.
Prehosp Emerg Care. 2011 Jan-Mar;15(1):88-97. doi: 10.3109/10903127.2010.531375.
Chest compression interruptions are detrimental during the resuscitation of cardiac arrest patients, especially immediately prior to shock delivery.
To evaluate the effect of use of a new defibrillator technology, which filters compression-induced artifact and provides reliable rhythm analysis with automatic defibrillator charging during chest compressions, on preshock chest compression interruption.
Thirty subjects (20 basic life support [BLS]; 10 advanced life support [ALS]) worked in pairs to perform two randomly ordered simulated cardiac resuscitations with the defibrillator operating in either standard mode (ALS = manual; BLS = automated external defibrillator [AED]) or the new Analysis and Charging during CPR (AC-CPR) mode. During each resuscitation simulation, rescuers switched roles as chest compressor and defibrillator operator every two segments of CPR (one segment = 2 minutes of chest compressions, rhythm analysis, and shock delivery, if appropriate), for eight total segments. The participants rested ≥30 minutes between trials and received brief AC-CPR training (BLS = 30 seconds; ALS = 5 minutes). Heart rate and perceived exertion were measured with pulse oximetry and the Borg scale, respectively.
Mean (± standard deviation) preshock chest compression pause time was considerably shorter in each CPR segment with AC-CPR versus standard defibrillator operation (2.13 ± 0.99 sec vs. 10.93 ± 1.33, p < 0.0001), demonstrating effective use of AC-CPR with minimal training. Despite reduced chest compression interruption with AC-CPR, rescuer fatigue and perceived exertion did not differ in any CPR segment with standard defibrillator operation versus AC-CPR (p = 0.2-1.0).
Preshock pause time is reduced by 80% utilizing a novel technology that employs automated analysis and charging during chest compression. Although chest compression pause time is reduced with the use of the new technology, participants do not excessively fatigue.
在心脏骤停患者的复苏过程中，胸外按压中断是有害的，尤其是在电击前。
评估一种新的除颤器技术的效果，该技术可过滤按压引起的伪影，并在按压过程中自动除颤器充电时提供可靠的节律分析，以减少电击前的胸外按压中断。
30 名受试者（20 名基础生命支持[BLS]；10 名高级生命支持[ALS]）成对工作，使用除颤器以标准模式（ALS=手动；BLS=自动体外除颤器[AED]）或新的分析和心肺复苏期间充电（AC-CPR）模式进行两次随机顺序的模拟心肺复苏。在每次复苏模拟中，救援人员每两个 CPR 段（一个段=2 分钟的胸外按压、节律分析和电击，如需要）就切换一次胸外按压者和除颤器操作员的角色，共 8 个段。参与者在试验之间至少休息 30 分钟，并接受简短的 AC-CPR 培训（BLS=30 秒；ALS=5 分钟）。心率和感知用力分别用脉搏血氧仪和 Borg 量表测量。
与标准除颤器操作相比，AC-CPR 每个 CPR 段的电击前胸外按压暂停时间明显缩短（2.13±0.99 秒比 10.93±1.33 秒，p<0.0001），表明经过最小的培训即可有效地使用 AC-CPR。尽管使用 AC-CPR 减少了胸外按压中断，但在标准除颤器操作与 AC-CPR 相比的任何 CPR 段，救援人员的疲劳和感知用力均无差异（p=0.2-1.0）。
利用一种新的技术，在胸外按压过程中采用自动分析和充电，可将电击前的暂停时间减少 80%。虽然新的技术可以减少胸外按压的暂停时间，但参与者并没有过度疲劳。
