National and Kapodistrian University of Athens, Medical School, MSc Cardiopulmonary Resuscitation, Athens, Greece.
Int J Cardiol. 2013 Sep 1;167(5):1703-11. doi: 10.1016/j.ijcard.2012.11.077. Epub 2012 Dec 6.
Human exposure to high altitude is increasing, through inhabitation of areas of high altitude, expansion of tourism into more remote areas, and air travel exposing passengers to typical altitudes equivalent to 8005 ft (2440 m). With ascent to high altitude, a number of acute and chronic physiological changes occur, influencing all systems of the human body. When considering that cardiac arrest is the second most common cause of death in the mountains and that up to 60% of the elderly have significant heart disease or other health problems, these changes are of particular importance as they may have a significant impact on resuscitation efforts. Current guidelines for resuscitation lack specific recommendations regarding treatment of cardiac arrest after ascent to high altitude or in aircraft. Therefore, we performed a comprehensive search in PubMed, CINAHL, Cochrane Library, and Scopus databases for studies relevant to resuscitation at high altitude. As no randomized trials evaluating the effects of physiological changes after ascent to high altitude on cardiopulmonary resuscitation were identified, our search was expanded to include all studies addressing important aspects on high altitude physiology which could have a potential impact on the resuscitation of cardiac arrest victims. The aim of this review is to discuss the major physiological changes occurring after ascent to high altitude and their potential effects on cardiopulmonary resuscitation. Based on the available data, specific suggestions are proposed regarding resuscitation at high altitude.
人类暴露在高海拔环境中的情况正在增加，这可能是由于人们居住在高海拔地区、旅游业向更偏远地区扩张，以及航空旅行使乘客暴露在相当于 8005 英尺（2440 米）的典型海拔高度。当海拔升高时，人体会发生许多急性和慢性的生理变化，影响身体的所有系统。考虑到心脏骤停是山区第二大常见死因，而且高达 60%的老年人有严重的心脏病或其他健康问题，这些变化尤其重要，因为它们可能对复苏努力产生重大影响。目前的复苏指南缺乏针对高原上升后或飞机上心脏骤停治疗的具体建议。因此，我们在 PubMed、CINAHL、Cochrane 图书馆和 Scopus 数据库中进行了全面检索，以寻找与高海拔复苏相关的研究。由于没有随机试验评估高原上升后生理变化对心肺复苏的影响，我们的搜索范围扩大到包括所有探讨高原生理学重要方面的研究，这些研究可能对心脏骤停患者的复苏产生潜在影响。本综述的目的是讨论海拔升高后发生的主要生理变化及其对心肺复苏的潜在影响。基于现有数据，我们针对高海拔复苏提出了具体建议。
