Department of Mechanical and Mechatronic Engineering, University of Stellenbosch, Private Bag X1 Matieland, Stellenbosch 7602, Western Cape, South Africa.
Med Biol Eng Comput. 2011 Sep;49(9):1057-65. doi: 10.1007/s11517-011-0812-5. Epub 2011 Jul 23.
The aim of this study is to determine the conditions necessary to achieve optimum chest compression (CC) performance during constant peak displacement cardiopulmonary resuscitation (CPR). This was accomplished by first performing a sensitivity analysis on a theoretical constant peak displacement CPR CC model to identify the parameters with the highest sensitivity. Next, the most sensitive parameters were then optimized for net sternum-to-spine compression depth, using a two-variable non-linear least squares method. The theoretical CC model was found to be most sensitive to: thoracic stiffness, maximum sternal displacement, CC rate, and back support stiffness. Based on a two-variable, non-linear least squares analysis to optimize the model for the net sternum-to-spine compression depth during constant peak displacement CPR, it was found that the optimum ranges for the CC rate and back support stiffness are between 40-120 cpm and 241.0-1198.5 Ncm⁻¹, respectively. Clinically, this suggests that current ERC guidelines for the CC rate during peak displacement CPR are appropriate; however, practitioners should be aware that the stiffness of the back support surfaces found in many hospitals may be sub-optimal and should consider using a backboard or a concrete floor to enhance CPR effectiveness.
本研究旨在确定在恒定峰值位移心肺复苏（CPR）期间实现最佳胸部按压（CC）性能的条件。这是通过对理论恒定峰值位移 CPR CC 模型进行灵敏度分析来完成的，以确定灵敏度最高的参数。接下来，使用双变量非线性最小二乘法对最敏感的参数进行优化，以获得净胸骨-脊柱压缩深度。理论 CC 模型对以下参数最敏感：胸廓刚度、胸骨最大位移、CC 率和背部支撑刚度。基于双变量非线性最小二乘法分析，对恒定峰值位移 CPR 期间的净胸骨-脊柱压缩深度优化模型，发现 CC 率和背部支撑刚度的最佳范围分别为 40-120 cpm 和 241.0-1198.5 Ncm⁻¹。临床上，这表明目前 ERC 指南中关于峰值位移 CPR 期间 CC 率的指南是合适的；然而，从业者应该意识到，许多医院使用的背部支撑面的刚度可能不理想，应考虑使用背板或混凝土地板来提高 CPR 效果。
