Matevossian Edouard, Doll Dietrich, Säckl Jakob, Sinicina Inga, Schneider Jürgen, Simon Gerhard, Hüser Norbert
Department of Surgery, Technische Universität of Munich, Germany.
Department of Visceral, Vascular and Thoracic Surgery, Philips University of Marburg, Marburg Germany.
Open Access Emerg Med. 2009 May 6;1:1-4. doi: 10.2147/oaem.s5210. eCollection 2009.
Saving more human lives through more effective reanimation measures is the goal of the new international guidelines on cardiopulmonary resuscitation as the decisive aspect for survival after cardiovascular arrest is that basic resuscitation should start immediately. According to the updated guidelines, the greatest efficacy in cardiac massage is only achieved when the right compression point, an adequate compression depth, vertical pressure, the correct frequency, and equally long phases of compression and decompression are achieved. The very highest priority is placed on restoring continuous circulation. Against this background, standardized continuous chest compression with active decompression has contributed to a favorable outcome in this case. The hydraulically operated and variably adjustable automatic Lund University Cardiac Arrest System (LUCAS) device (Jolife, Lund, Sweden) undoubtedly meets these requirements. This case report describes a 44-year-old patient who - approximately 15 min after the onset of clinical death due to apparent ventricular fibrillation - received cardiopulmonary resuscitation, initially by laypersons and then by the emergency medical team (manual chest compressions followed by situation-adjusted LUCAS compressions). Sinus rhythm was restored after more than 90 min of continuous resuscitation, with seven defibrillations. Interventional diagnostic workup did not reveal a causal morphological correlate for the condition on coronary angiography. After a 16-day period of hospital convalescence, with preventive implantation of an implantable cardioverter defibrillator and several weeks of rehabilitation, the patient was able to return home with no evidence of health impairment.
通过更有效的复苏措施挽救更多人的生命，是新的国际心肺复苏指南的目标，因为心脏骤停后生存的决定性因素是基本复苏应立即开始。根据最新指南，只有在找到正确的按压点、达到足够的按压深度、垂直施压、保持正确的频率以及按压和减压阶段时长相等时，心脏按压才能达到最大效果。恢复持续循环被置于最优先地位。在此背景下，标准化的主动减压持续胸外按压在该病例中取得了良好效果。液压操作且可调节的隆德大学心脏骤停自动系统（LUCAS）设备（瑞典隆德的Jolife公司）无疑满足了这些要求。本病例报告描述了一名44岁患者，因明显室颤导致临床死亡约15分钟后接受了心肺复苏，最初由非专业人员进行，随后由紧急医疗团队接手（先进行徒手胸外按压，然后根据情况调整为LUCAS按压）。经过90多分钟的持续复苏及7次除颤后恢复了窦性心律。介入诊断检查未在冠状动脉造影中发现导致该病症的形态学相关病因。经过16天的住院康复，预防性植入了植入式心脏复律除颤器并进行了数周康复治疗后，患者得以回家，未出现健康受损迹象。
