Abella Benjamin S
Department of Emergency Medicine, Center for Resuscitation Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Curr Opin Crit Care. 2016 Jun;22(3):218-24. doi: 10.1097/MCC.0000000000000296.
Cardiopulmonary resuscitation (CPR) represents the cornerstone of cardiac arrest resuscitation care. Prompt delivery of high-quality CPR can dramatically improve survival outcomes; however, the definitions of optimal CPR have evolved over several decades. The present review will discuss the metrics of CPR delivery, and the evidence supporting the importance of CPR quality to improve clinical outcomes.
The introduction of new technologies to quantify metrics of CPR delivery has yielded important insights into CPR quality. Investigations using CPR recording devices have allowed the assessment of specific CPR performance parameters and their relative importance regarding return of spontaneous circulation and survival to hospital discharge. Additional work has suggested new opportunities to measure physiologic markers during CPR and potentially tailor CPR delivery to patient requirements.
Through recent laboratory and clinical investigations, a more evidence-based definition of high-quality CPR continues to emerge. Exciting opportunities now exist to study quantitative metrics of CPR and potentially guide resuscitation care in a goal-directed fashion. Concepts of high-quality CPR have also informed new approaches to training and quality improvement efforts for cardiac arrest care.
心肺复苏(CPR)是心脏骤停复苏治疗的基石。及时实施高质量的心肺复苏可显著改善生存结局;然而,最佳心肺复苏的定义在几十年间不断演变。本综述将讨论心肺复苏实施的指标,以及支持心肺复苏质量对改善临床结局重要性的证据。
引入新技术来量化心肺复苏实施的指标,为心肺复苏质量提供了重要见解。使用心肺复苏记录设备的研究能够评估特定的心肺复苏操作参数,以及它们在自主循环恢复和存活至出院方面的相对重要性。更多研究提出了在心肺复苏期间测量生理指标的新机会,并有可能根据患者需求调整心肺复苏的实施。
通过近期的实验室和临床研究,高质量心肺复苏的定义正不断基于更多证据而形成。目前存在令人兴奋的机会来研究心肺复苏的量化指标,并有可能以目标导向的方式指导复苏治疗。高质量心肺复苏的概念也为心脏骤停护理的培训和质量改进工作提供了新方法。