Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA.
Crit Care Med. 2012 Nov;40(11):3007-12. doi: 10.1097/CCM.0b013e31825d924d.
When the duration of cardiac arrest is prolonged, reperfusion of the vital organs by effective chest compression is the most important intervention for successful resuscitation. We investigated the effects of a newly developed miniaturized chest compressor on the outcomes of cardiopulmonary resuscitation.
Prospective, randomized, controlled experimental study.
University-affiliated animal research laboratory.
Thirty male domestic pigs.
Ventricular fibrillation was induced in 30 male domestic pigs weighing 35 ± 2 kg. Cardiopulmonary resuscitation was initiated after 7 mins of untreated ventricular fibrillation. The animals were randomized to receive mechanical chest compression with a miniaturized chest compressor, a LUCAS device or a Thumper device. After 5 mins of cardiopulmonary resuscitation, a 150-J defibrillation was delivered. If resuscitation was not successful, cardiopulmonary resuscitation was continued for 2 mins before the next defibrillation. The protocol was continued until successful resuscitation or for a total of 15 mins of cardiopulmonary resuscitation. The animals were observed for 72 hrs after resuscitation.
The miniaturized chest compressor generated significantly greater coronary perfusion pressure, end-tidal PCO2, carotid blood flow, and intrathoracic negative pressure, with significantly lower compression depth and fewer rib fractures when compared with both the LUCAS and Thumper devices. Both the miniaturized chest compressor and LUCAS devices required lower numbers of defibrillation for successful resuscitation when compared with the Thumper device. This was associated with lower prevalence of recurrent ventricular fibrillation and better postresuscitation myocardial and neurological function when compared with the Thumper device.
The miniaturized chest compressor improves hemodynamic efficacy and the success of cardiopulmonary resuscitation with significantly less injury, which is as effective as the LUCAS device. It may provide a new option for cardiopulmonary resuscitation.
当心脏骤停持续时间延长时，通过有效胸外按压使重要器官再灌注是复苏成功的最重要干预措施。我们研究了一种新开发的微型胸部按压机对心肺复苏结局的影响。
前瞻性、随机、对照实验研究。
大学附属动物研究实验室。
30 只雄性家猪。
在 30 只体重 35±2kg 的雄性家猪中诱发心室颤动。在未经治疗的心室颤动 7 分钟后开始心肺复苏。将动物随机分为接受微型胸部按压机、LUCAS 设备或 Thumper 设备进行机械胸外按压。心肺复苏 5 分钟后，给予 150-J 除颤。如果复苏不成功，在进行下一次除颤之前，心肺复苏继续进行 2 分钟。该方案继续进行，直至复苏成功或心肺复苏总共进行 15 分钟。复苏后观察动物 72 小时。
与 LUCAS 和 Thumper 设备相比，微型胸部按压机产生的冠状动脉灌注压、呼气末 PCO2、颈动脉血流和胸腔内负压显著更大，压缩深度显著更低，肋骨骨折更少。与 Thumper 设备相比，微型胸部按压机和 LUCAS 设备需要更少的除颤次数才能成功复苏。这与复发性心室颤动的发生率较低以及与 Thumper 设备相比，复苏后心肌和神经功能更好相关。
微型胸部按压机通过显著减少损伤来提高血流动力学效果和心肺复苏的成功率，与 LUCAS 设备一样有效。它可能为心肺复苏提供一种新的选择。
