López Jorge, Fernández Sarah N, González Rafael, Solana María J, Urbano Javier, Toledo Blanca, López-Herce Jesús
Pediatric Intensive Care Department, Gregorio Marañón General University Hospital, Madrid, Spain.
Pediatrics Department, School of Medicine, Complutense University of Madrid, Spain.
PLoS One. 2017 Nov 30;12(11):e0188846. doi: 10.1371/journal.pone.0188846. eCollection 2017.
Chest compressions (CC) during cardiopulmonary resuscitation are not sufficiently effective in many circumstances. Mechanical CC could be more effective than manual CC, but there are no studies comparing both techniques in children. The objective of this study was to compare the effectiveness of manual and mechanical chest compressions with Thumper device in a pediatric cardiac arrest animal model.
An experimental model of asphyxial cardiac arrest (CA) in 50 piglets (mean weight 9.6 kg) was used. Animals were randomized to receive either manual CC or mechanical CC using a pediatric piston chest compressions device (Life-Stat®, Michigan Instruments). Mean arterial pressure (MAP), arterial blood gases and end-tidal CO2 (etCO2) values were measured at 3, 9, 18 and 24 minutes after the beginning of resuscitation.
There were no significant differences in MAP, DAP, arterial blood gases and etCO2 between chest compression techniques during CPR. Survival rate was higher in the manual CC (15 of 30 = 50%) than in the mechanical CC group (3 of 20 = 15%) p = 0.016. In the mechanical CC group there was a non significant higher incidence of haemorrhage through the endotracheal tube (45% vs 20%, p = 0.114).
In a pediatric animal model of cardiac arrest, mechanical piston chest compressions produced lower survival rates than manual chest compressions, without any differences in hemodynamic and respiratory parameters.
在许多情况下,心肺复苏期间的胸外按压(CC)效果并不理想。机械胸外按压可能比徒手胸外按压更有效,但尚无针对儿童比较这两种技术的研究。本研究的目的是在小儿心脏骤停动物模型中比较徒手胸外按压和使用Thumper设备进行机械胸外按压的效果。
使用50头仔猪(平均体重9.6千克)建立窒息性心脏骤停(CA)实验模型。动物被随机分为两组,分别接受徒手胸外按压或使用小儿活塞式胸外按压设备(Life-Stat®,密歇根仪器公司)进行机械胸外按压。在复苏开始后3、9、18和24分钟测量平均动脉压(MAP)、动脉血气和呼气末二氧化碳(etCO2)值。
心肺复苏期间,两种胸外按压技术在MAP、舒张压(DAP)、动脉血气和etCO2方面无显著差异。徒手胸外按压组的生存率(30头中的15头 = 50%)高于机械胸外按压组(20头中的3头 = 15%),p = 0.016。在机械胸外按压组中,气管内出血的发生率较高,但差异无统计学意义(45% 对20%,p = 0.114)。
在小儿心脏骤停动物模型中,机械活塞式胸外按压的生存率低于徒手胸外按压,在血流动力学和呼吸参数方面无差异。