Nolan Jerry P
Royal United Hospital, Bath, UK.
Curr Opin Crit Care. 2014 Jun;20(3):227-33. doi: 10.1097/MCC.0000000000000083.
The quality of cardiopulmonary resuscitation (CPR) impacts on outcome after cardiac arrest. This review will explore the factors that contribute to high-quality CPR and the metrics that can be used to monitor performance.
A recent consensus statement from North America defined five key components of high-quality CPR: minimizing interruptions in chest compressions, providing compressions of adequate rate and depth, avoiding leaning on the chest between compressions, and avoiding excessive ventilation. Studies have shown that real-time feedback devices improve the quality of CPR and, in one before-and-after study, outcome from out-of-hospital cardiac arrest.
There is evidence for increasing survival rates following out-of-hospital cardiac arrest and this is associated with increasing rates of bystander CPR. The quality of CPR provided by healthcare professionals can be improved with real-time feedback devices. The components of high-quality CPR and the metrics that can be measured and fed back to healthcare professionals have been defined by expert consensus. In the future, real-time feedback based on the physiological responses to CPR may prove more effective.
心肺复苏（CPR）的质量会影响心脏骤停后的预后。本综述将探讨有助于高质量心肺复苏的因素以及可用于监测操作表现的指标。
北美近期的一份共识声明定义了高质量心肺复苏的五个关键要素：尽量减少胸外按压中断、提供足够速率和深度的按压、避免按压间隙倚靠胸部以及避免过度通气。研究表明，实时反馈设备可提高心肺复苏质量，且在一项前后对照研究中，可改善院外心脏骤停的预后。
有证据表明院外心脏骤停后的生存率在提高，这与旁观者心肺复苏率的增加有关。使用实时反馈设备可提高医护人员实施心肺复苏的质量。高质量心肺复苏的要素以及可测量并反馈给医护人员的指标已通过专家共识确定。未来，基于心肺复苏生理反应的实时反馈可能会更有效。
