救生员胸外按压频率对复苏质量的影响。一项前瞻性随机交叉多中心模拟试验。
The effect of chest compression frequency on the quality of resuscitation by lifeguards. A prospective randomized crossover multicenter simulation trial.
机构信息
Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland., Wroclaw, Poland.
Lazarski University, Warsaw, Poland.
出版信息
Cardiol J. 2019;26(6):769-776. doi: 10.5603/CJ.a2018.0121. Epub 2018 Oct 19.
BACKGROUND
The ability to perform high-quality cardiopulmonary resuscitation is one of the basic skills for lifeguards. The aim of the study was to assess the influence of chest compression frequency on the quality of the parameters of chest compressions performed by lifeguards.
METHODS
This prospective observational, randomized, crossover simulation study was performed with 40 lifeguards working in Warsaw, Wroclaw, and Poznan, Poland. The subjects then participated in a target study, in which they were asked to perform 2-min cycles of metronome-guided chest compressions at different rates: 80, 90, 100, 110, 120, 130, 140, and 150 compressions per minute (CPM).
RESULTS
The study involved 40 lifeguards. Optimal chest compression score calculated by manikin software was achieved for 110-120 CPM. Chest compression depth achieved 53 (interquartile range [IQR] 52-54) mm, 56 (IQR 54-57) mm, 52.5 (IQR 50-54) mm, 53 (IQR 52-53) mm, 50 (IQR 49-51) mm, 47 (IQR 44-51) mm, 41 (IQR 40-42) mm, 38 (IQR 38-43) mm for 80, 90, 100, 110, 120, 130, 140 and 150 CPM, respectively. The percentage of chest compressions with the correct depth was lower for rates exceeding 120 CPM.
CONCLUSIONS
The rate of 100-120 CPM, as recommended by international guidelines, is the optimal chest compression rate for cardiopulmonary resuscitation performed by lifeguards. A rate above 120 CPM was associated with a dramatic decrease in chest compression depth and overall chest compression quality. The role of full chest recoil should be emphasized in basic life support training.
背景
进行高质量心肺复苏是救生员的基本技能之一。本研究旨在评估胸外按压频率对救生员实施的胸外按压参数质量的影响。
方法
这是一项在波兰华沙、弗罗茨瓦夫和波兹南进行的前瞻性观察性、随机、交叉模拟研究，共有 40 名救生员参与。然后，受试者参加了一项目标研究，要求他们以每分钟 80、90、100、110、120、130、140 和 150 次的不同频率进行 2 分钟节拍器引导的胸外按压循环。
结果
研究共涉及 40 名救生员。通过人偶软件计算出的最佳胸外按压评分在 110-120 CPM 时达到。胸外按压深度为 53（四分位距 [IQR] 52-54）mm、56（IQR 54-57）mm、52.5（IQR 50-54）mm、53（IQR 52-53）mm、50（IQR 49-51）mm、47（IQR 44-51）mm、41（IQR 40-42）mm、38（IQR 38-43）mm，分别对应 80、90、100、110、120、130、140 和 150 CPM。超过 120 CPM 的频率时，正确深度的胸外按压比例较低。
结论
国际指南推荐的 100-120 CPM 是救生员进行心肺复苏的最佳胸外按压频率。超过 120 CPM 的频率与胸外按压深度和整体胸外按压质量的急剧下降有关。在基础生命支持培训中应强调充分的胸廓回弹作用。
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