Piacentini Alberto, Volonte' Maurizio, Rigamonti Marcello, Guastella Elisa, Landriscina Mario
Anesthesiology-118 Service AAT Como, Italy ; Azienda Ospedaliera Sant'Anna, via Ravona, 1 22020 San Fermo della Battaglia (CO), Italy.
Case Rep Emerg Med. 2012;2012:381798. doi: 10.1155/2012/381798. Epub 2012 Aug 23.
Mechanical cardiopulmonary resuscitation (m-CPR) devices are an alternative to manual CPR, but their efficacy has been subject to debate. We present a case of a patient with full-neurologic recovery after prolonged m-CPR. The patient presented with severe hypothermia (internal temperature 24°C) and poisoning (sedatives/hypnotics). Hepatic perfusion and metabolism are considered keys to restore spontaneous circulation. During this period no problems related to the device or patient positioning were encountered. Delivery of high-quality CPR and prolonged resuscitation were achieved. We confirm that ventilations asynchronous with chest compressions can be a problem. Reduction in chest measurements can hamper lung ventilation. A synchronous mode of manual ventilation (30 : 2) seems to be the best solution. The patient had an initial period of manual CPR. No damage to any organ or structure was noted. This case is of further interest because our EMS helicopters can fly 24 hours a day and m-CPR devices could play an important role as a "bridge" in patients when active rewarming by cardiopulmonary bypass is indicated (CPB).
机械心肺复苏（m-CPR）设备是手动心肺复苏的替代方案，但其疗效一直存在争议。我们报告一例患者在长时间m-CPR后实现了完全神经功能恢复。该患者表现为严重体温过低（核心温度24°C）和中毒（镇静剂/催眠药）。肝脏灌注和代谢被认为是恢复自主循环的关键。在此期间，未遇到与设备或患者体位相关的问题。实现了高质量心肺复苏和长时间复苏。我们确认胸外按压与通气不同步可能是个问题。胸廓尺寸减小会妨碍肺通气。手动通气同步模式（30∶2）似乎是最佳解决方案。该患者开始时进行了手动心肺复苏。未发现对任何器官或结构的损伤。该病例更具意义，因为我们的急救医疗服务直升机能够一天24小时飞行，并且当需要通过体外循环（CPB）进行积极复温时，m-CPR设备在患者中可作为“桥梁”发挥重要作用。
