Department of Family Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea.
Eur J Emerg Med. 2011 Oct;18(5):251-6. doi: 10.1097/MEJ.0b013e328345340f.
Inadequate chest compressions during cardiopulmonary resuscitation (CPR) may be insufficient to provide the required blood flow to preserve critical organ function. The purpose of this study was to evaluate the influence of the CPR provider's physical fitness on the quality of chest compression and physiological changes during continuous chest compressions for 5 min. We also investigated the possible effects of rescuer's sex, weight, and height on the quality of CPR performed.
Forty-seven participants performed uninterrupted chest compressions on a manikin for 5 min. Before performing CPR, the physical fitness of every candidate was assessed using common measures of physical fitness, including maximal aerobic exercise capacity, muscle strength, muscle power, muscle endurance, and reactive agility. To evaluate the physical strain, we monitored the ratings of perceived exertion score, heart rate, minute ventilation volume, volume of carbon dioxide production per minute, and volume of oxygen consumption per minute during CPR performance.
There was a significant reduction in the percentage of correct compressions after the first minute: 78.8% in the first, 57.2% in the second, 43.4% in the third, 36.5% in the fourth, and 28.0% in the fifth minute (P<0.001). We observed good correlations between the numbers of correct compressions with muscle strength at each minute except the first minute. In multiple regression analyses, only muscle strength affects the quality of correct chest compression (R=49.4%, P<0.05).
The results of this study suggest that a fitness program, such as muscle strength exercise for CPR providers, should be considered for improving survival from cardiac arrest.
心肺复苏（CPR）过程中，如果按压深度不足，可能无法提供维持重要器官功能所需的血流。本研究旨在评估心肺复苏者的体能对连续按压 5 分钟时的胸外按压质量和生理变化的影响。我们还研究了救援人员的性别、体重和身高对所实施的心肺复苏质量的可能影响。
47 名参与者在模型上不间断地进行胸外按压 5 分钟。在进行心肺复苏之前，使用常见的体能测试评估每位候选人的体能，包括最大有氧运动量、肌肉力量、肌肉爆发力、肌肉耐力和反应敏捷性。为了评估体力消耗，我们在进行心肺复苏期间监测了感知用力评分、心率、分钟通气量、每分钟二氧化碳产生量和每分钟耗氧量。
第一次按压后，正确按压的百分比显著下降：第 1 分钟为 78.8%，第 2 分钟为 57.2%，第 3 分钟为 43.4%，第 4 分钟为 36.5%，第 5 分钟为 28.0%（P<0.001）。我们观察到，除了第 1 分钟之外，每个分钟的正确按压次数与肌肉力量之间存在良好的相关性。在多元回归分析中，只有肌肉力量会影响正确的胸外按压质量（R=49.4%，P<0.05）。
本研究结果表明，对于心肺复苏者，应考虑进行体能计划，如肌肉力量训练，以提高心脏骤停的存活率。
