Smereka Jacek, Szarpak Lukasz, Smereka Adam, Leung Steve, Ruetzler Kurt
Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.
Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.
Am J Emerg Med. 2017 Apr;35(4):604-609. doi: 10.1016/j.ajem.2016.12.045. Epub 2016 Dec 19.
The impact of high-quality chest compressions during CPR for the patients' outcome is undisputed, as it is essential for maintaining vital organ perfusion. The aim of our study is to compare the quality of chest compression (CC) and ventilation among the two current standard techniques with our novel "nTTT" technique in infant CPR.
In this randomized crossover, manikin trial, participants performed CCs using three techniques in a randomized sequence: standard two finger technique (TFT); standard two thumb technique (TTHT), and the 'new two-thumb technique' (nTTT). The novel method of CCs in an infant consists in using two thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist.
Median depth compression using the distinct chest compression techniques varied and amounted to 26 [IQR, 25-28] mm for TFT, and 39 [IQR, 39-39] mm for TTHT as well as for nTTT. Best percentage of fully released compressions were received using TFT (100[100-100] %), then in the case of nTTT (99[98-100] %), and the worst in situation where TTHT (18[14-19] %). was used. The fastest chest compression rate was achieved with TFT (134[IQR, 129-135]/min) and the slowest when using nTTT (109 [IQR, 105-111]/min).
We found that our new nTTT technique's performance, in terms of compression depth, hands-off time, and ventilation quality, is comparable to the current standards. Based on our findings of this initial manikin study, the nTTT technique is superior to TFT in many of parameters that are vital to a quality chest compression during pediatric CPR.
高质量心肺复苏期间胸外按压对患者预后的影响是无可争议的，因为它对维持重要器官灌注至关重要。我们研究的目的是比较目前两种标准技术与我们新颖的“nTTT”技术在婴儿心肺复苏中胸外按压（CC）和通气的质量。
在这项随机交叉模拟人试验中，参与者按随机顺序使用三种技术进行胸外按压：标准两指法（TFT）；标准双拇指法（TTHT），以及“新双拇指法”（nTTT）。婴儿胸外按压的新方法是双手握拳，双拇指与胸部呈90°角。
使用不同胸外按压技术的中位按压深度各不相同，TFT为26[四分位间距，25 - 28]毫米，TTHT和nTTT均为39[四分位间距，39 - 39]毫米。完全放松按压的最佳百分比在使用TFT时为100[100 - 100]%，其次是nTTT（99[98 - 100]%），最差的是使用TTHT时（18[14 - 十九]%）。胸外按压速度最快的是TFT（134[四分位间距，129 - 135]/分钟），使用nTTT时最慢（109[四分位间距，105 - 111]/分钟）。
我们发现，我们的新nTTT技术在按压深度、手离开时间和通气质量方面的表现与当前标准相当。基于我们这项初步模拟人研究的结果，在儿科心肺复苏期间对高质量胸外按压至关重要的许多参数方面，nTTT技术优于TFT。
