Gould Jeffrey R, Campana Lisa, Rabickow Danielle, Raymond Richard, Partridge Robert
ZOLL Medical, Chelmsford, MA, USA.
Armstrong Ambulance, Arlington, MA, USA.
Int J Emerg Med. 2020 Apr 16;13(1):18. doi: 10.1186/s12245-020-00276-y.
Manual ventilations during cardiac arrest are frequently performed outside of recommended guidelines. Real-time feedback has been shown to improve chest compression quality, but the use of feedback to guide ventilation volume and rate has not been studied. The purpose of this study was to determine whether the use of a real-time visual feedback system for ventilation volume and rate improves manual ventilation quality during simulated cardiac arrest.
Teams of 2 emergency medical technicians (EMTs) performed two 8-min rounds of cardiopulmonary resuscitation (CPR) on a manikin during a simulated cardiac arrest scenario with one EMT performing ventilations while the other performed compressions. The EMTs switched roles every 2 min. During the first round of CPR, ventilation and chest compression feedback was disabled on a monitor/defibrillator. Following a 20-min rest period and a brief session to familiarize the EMTs with the feedback technology, the trial was repeated with feedback enabled. The primary outcome variables for the study were ventilations and chest compressions within target. Ventilation rate (target, 8-10 breaths/minute) and tidal volume (target, 425-575 ml) were measured using a novel differential pressure-based flow sensor. Data were analyzed using paired t tests.
Ten teams of 2 EMTs completed the study. Mean percentages of ventilations performed in target for rate (41% vs. 71%, p < 0.01), for volume (31% vs. 79%, p < 0.01), and for rate and volume together (10% vs. 63%, p < 0.01) were significantly greater with feedback.
The use of a novel visual feedback system for ventilation quality increased the percentage of ventilations in target for rate and volume during simulated CPR. Real-time feedback to perform ventilations within recommended guidelines during cardiac arrest should be further investigated in human resuscitation.
心脏骤停期间的人工通气常常未按照推荐指南进行。实时反馈已被证明可改善胸外按压质量，但利用反馈来指导通气量和频率尚未得到研究。本研究的目的是确定使用针对通气量和频率的实时视觉反馈系统是否能在模拟心脏骤停期间改善人工通气质量。
在模拟心脏骤停场景中，由两名急救医疗技术员（EMT）组成的团队在模拟人上进行两轮8分钟的心肺复苏（CPR），一名EMT进行通气，另一名进行按压。EMT每2分钟交换一次角色。在第一轮CPR期间，监护除颤仪上的通气和胸外按压反馈功能被禁用。经过20分钟的休息期以及让EMT熟悉反馈技术的简短环节后，在反馈功能启用的情况下重复该试验。该研究的主要结局变量是处于目标范围内的通气和胸外按压。使用一种新型的基于差压的流量传感器测量通气频率（目标值为8 - 10次/分钟）和潮气量（目标值为425 - 575毫升）。数据采用配对t检验进行分析。
十组由两名EMT组成的团队完成了该研究。有反馈时，通气频率处于目标范围内的平均百分比（41%对71%，p < 0.01）、通气量处于目标范围内的平均百分比（31%对79%，p < 0.01）以及通气频率和通气量均处于目标范围内的平均百分比（10%对63%，p < 0.01）均显著更高。
使用针对通气质量的新型视觉反馈系统可提高模拟心肺复苏期间通气频率和通气量处于目标范围内的百分比。在心脏骤停期间按照推荐指南进行通气的实时反馈应在人体复苏中进一步研究。
