López-González Angel, Sánchez-López Mairena, Garcia-Hermoso Antonio, López-Tendero Jaime, Rabanales-Sotos Joseba, Martínez-Vizcaíno Vicente
School of Nursing, University of Castilla-La Mancha, Albacete, Spain.
University of Castilla-La Mancha, Health and Social Research Centre, Cuenca, Spain.
Am J Emerg Med. 2016 Sep;34(9):1845-9. doi: 10.1016/j.ajem.2016.06.058. Epub 2016 Jun 16.
It has been hypothesized that body mass index (BMI) and muscle strength (MS) of the rescuers are predictors of adequate external chest compressions (ECC). The aims of this study were: (a) to analyze, in college students, the relationship between BMI and MS with adequate ECC parameters; and (b) to examine whether the association between BMI and adequate ECC parameters is mediated by MS.
A cross-sectional analysis of the evaluation of a CPR performance test involving students (n=63). We determined BMI and MS. After previous training, participants performed cardiopulmonary resuscitation on a mannequin for 20 minutes. PROCESS macro developed by Preacher and Hayes was used to assess whether the association between BMI and ECC was mediated by MS.
Underweight subjects achieved lower results than those with normal weight and overweight/obese in several dependent variables including: correct compression depth (P<.001) and adequate ECC (P<.001). This differences remained after adjusting for muscle strength except for the compression rate (P=.053). Moreover, participants in the low MS quartile were lower in both correct compression depth (P=.001) and adequate ECC (P<.001) than participants in the medium/high quartile after adjusting for confounding variables. The effect of BMI on adequate ECC was partially mediated by MS. Similar results were obtained in the analysis of the mediator role of MS in the relationship between BMI and correct compression depth.
The ability to provide adequate ECC is influenced by the rescuer's MS. Rescuers should be advised to exercise arm strength to improve the quality of CPR.
据推测，救援者的体重指数（BMI）和肌肉力量（MS）是进行充分胸外按压（ECC）的预测指标。本研究的目的是：（a）分析大学生中BMI和MS与充分ECC参数之间的关系；（b）检验BMI与充分ECC参数之间的关联是否由MS介导。
对一项涉及学生（n = 63）的心肺复苏性能测试评估进行横断面分析。我们测定了BMI和MS。在先前的培训后，参与者在模拟人身上进行了20分钟的心肺复苏。使用Preacher和Hayes开发的PROCESS宏来评估BMI与ECC之间的关联是否由MS介导。
在几个因变量中，体重过轻的受试者比体重正常和超重/肥胖的受试者得分更低，包括：正确的按压深度（P <.001）和充分的ECC（P <.001）。除了按压频率（P =.053）外，在调整肌肉力量后，这些差异仍然存在。此外，在调整混杂变量后，低MS四分位数的参与者在正确按压深度（P =.001）和充分ECC（P <.001）方面均低于中/高四分位数的参与者。BMI对充分ECC的影响部分由MS介导。在分析MS在BMI与正确按压深度之间关系中的中介作用时也获得了类似结果。
提供充分ECC的能力受救援者MS的影响。应建议救援者锻炼手臂力量以提高心肺复苏的质量。
