Suto Takashi, Saito Shigeru, Tobe Masaru, Kanamoto Masafumi, Matsui Yusuke
Department of Anesthesiology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Department of Anesthesiology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Wilderness Environ Med. 2020 Mar;31(1):97-100. doi: 10.1016/j.wem.2019.10.008. Epub 2020 Feb 7.
We experienced a case involving prolonged cardiopulmonary resuscitation (CPR) during cardiac arrest on Mt. Fuji (3776 m), demanding lengthy exertion by the rescuers performing CPR. Considering the effects of exertion on the rescuers, we examined their percutaneous arterial oxygen saturation during simulated CPR and compared the effects of compression-only and conventional CPR at 3700 m above sea level. The effects of CPR on the physical condition of rescuers were examined at the summit of Mt. Fuji: three rescue staff equipped with pulse-oximeters performed CPR with or without breaths using a CPR mannequin. At 3700 m, the rescuers' heart rate increased during CPR regardless of the presence or absence of rescue breathing. Percutaneous arterial oxygen saturation measured in such an environment was reduced only when CPR without rescue breathing was performed. Scores on the Borg scale, a subjective score of fatigue, after CPR in a 3700 m environment were 13 to 15 of 20 (somewhat hard to hard). Performing CPR at high altitude exerts a significant physical effect upon the condition of rescuers. Compression-only CPR at high altitude may cause a deterioration in rescuer oxygenation, whereas CPR with rescue breathing might ameliorate such deterioration.
我们遇到了一个在富士山（海拔3776米）心脏骤停期间进行长时间心肺复苏（CPR）的案例，这要求实施心肺复苏的救援人员长时间用力。考虑到用力对救援人员的影响，我们在模拟心肺复苏过程中检测了他们的经皮动脉血氧饱和度，并比较了在海拔3700米处仅按压心肺复苏和传统心肺复苏的效果。在富士山山顶检测了心肺复苏对救援人员身体状况的影响：三名配备脉搏血氧仪的救援人员使用心肺复苏模拟人进行有或无呼吸的心肺复苏。在海拔3700米处，无论有无救援呼吸，救援人员在心肺复苏期间心率都会增加。仅在进行无救援呼吸的心肺复苏时，在这种环境下测得的经皮动脉血氧饱和度才会降低。在海拔3700米环境下进行心肺复苏后，Borg量表（一种主观疲劳评分）的得分在20分中为13至15分（有点累到累）。在高海拔地区进行心肺复苏对救援人员的身体状况有显著影响。高海拔地区仅按压心肺复苏可能会导致救援人员氧合恶化，而有救援呼吸的心肺复苏可能会改善这种恶化情况。
