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心脏泵重新加载:转运途中的院内复苏。

Cardio pump reloaded: in-hospital resuscitation during transport.

机构信息

Department of Anesthesia and Intensive Care Medicine, Armed Forces Medical Centre Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany,

出版信息

Intern Emerg Med. 2013 Oct;8(7):621-6. doi: 10.1007/s11739-013-0983-1. Epub 2013 Aug 9.

DOI:10.1007/s11739-013-0983-1
PMID:23929388
Abstract

High-quality chest compressions are crucial during resuscitation if a positive outcome is to be achieved. Sometimes a patient must be transported within the hospital while chest compressions are being performed. We compared different chest compression devices [animax mono (AM), AutoPulse(®) (AP) and LUCAS2™ (L2)] with manual chest compression using a manikin during transport from a fifth floor ward to the cardiac catheterization laboratory in the basement. Chest compressions were interrupted for 10.7 s to set up the AM, 15.3 s for the L2 and 23.5 s for the AP. The use of a mechanical device reduced transport times from 144.5 s when manual compressions were underway, to 126.8, 111.1 and 98.5 s with the AM, L2 and AP, respectively (p < 0.05). Transfer to the laboratory gurney required little or no interruption in chest compressions with the L2 (0.8 s) and AP (no interruption), compared with 10.3 s with the AP and 3.3 s for manual compressions. Manual compression frequency was 124 min(-1), compared with 100.4 min(-1) for the AM, 99.9 min(-1) for the L2 and 79.7 min(-1) for the AP. Compression depth did not change during transport in any group. Mechanical compression devices are suitable for use during transport, but are not clearly superior to manual compressions. Devices maintain the same compression depth, but fell short of current guidelines, as did manual compressions. Some interruptions occurred while the devices were set up. Further, patient studies are necessary to determine the clinical utility of these devices.

摘要

高质量的胸外按压在复苏过程中至关重要,如果要取得积极的结果。有时,患者必须在医院内进行运输,同时进行胸外按压。我们比较了不同的胸外按压设备[animax mono (AM)、AutoPulse(®) (AP)和 LUCAS2™ (L2)]与使用模拟人在从五楼病房转运到地下室心脏导管实验室时的手动胸外按压。为了设置 AM,需要中断胸外按压 10.7 秒,为了设置 L2 需要中断 15.3 秒,为了设置 AP 需要中断 23.5 秒。使用机械装置可将转运时间从手动按压时的 144.5 秒缩短至 AM 时的 126.8 秒、L2 时的 111.1 秒和 AP 时的 98.5 秒(p < 0.05)。与 AP 时的 10.3 秒和手动按压时的 3.3 秒相比,L2 和 AP 可在将患者转移到实验室担架时几乎无需中断胸外按压(分别为 0.8 秒和无中断)。手动按压频率为 124 次/分钟,而 AM 为 100.4 次/分钟,L2 为 99.9 次/分钟,AP 为 79.7 次/分钟。在任何一组中,转运过程中的按压深度都没有变化。机械压缩装置适用于转运过程中使用,但并不明显优于手动按压。这些设备保持相同的按压深度,但都不符合当前指南,手动按压也一样。在设置设备时会出现一些中断。此外,还需要进行患者研究以确定这些设备的临床实用性。

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本文引用的文献

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Transport with ongoing resuscitation: a comparison between manual and mechanical compression.持续复苏下的转运:手动与机械按压的比较。
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An audiovisual feedback device for compression depth, rate and complete chest recoil can improve the CPR performance of lay persons during self-training on a manikin.一种用于监测按压深度、速率和完全回弹的视听反馈装置,可提高非专业人员在使用模拟人进行自我训练时的 CPR 操作水平。
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