Service des Urgences, Cliniques Universitaires Saint-Luc, Brussels.
Département de Médecine Aiguë, Université Catholic Louvain, Louvain.
Curr Opin Crit Care. 2020 Jun;26(3):219-227. doi: 10.1097/MCC.0000000000000726.
The current review will give an overview of different possibilities to monitor quality of cardiopulmonary resuscitation (CPR) from a physiologic and a process point of view and how these two approaches can/should overlap.
Technology is evolving fast with a lot of opportunities to improve the CPR quality. The role of smartphones and wearables are step-by-step identified as also the possibilities to perform patient tailored CPR based on physiologic parameters. The first steps have been taken, but more are to be expected. In this context, the limits of what is possible with human providers will become more and more clear.
To perform high-quality CPR, at first, one should optimize rate, depth and pause duration supported by process monitoring tools. Second, the evolving technological evolution gives opportunities to measure physiologic parameters in real-time which will open the way for patient-tailored CPR. The role of ultrasound, cerebral saturation and end-tidal CO2 in measuring the quality of CPR needs to be further investigated as well as the possible ways of influencing these measured parameters to improve neurological outcome and survival.
本综述将从生理学和过程的角度概述监测心肺复苏(CPR)质量的不同可能性,以及这两种方法如何/应该重叠。
技术发展迅速,有很多机会可以提高 CPR 质量。智能手机和可穿戴设备的作用逐渐被确定,以及根据生理参数进行个体化 CPR 的可能性也逐渐被确定。已经迈出了第一步,但预计还会有更多的发展。在这种情况下,人类提供者的能力极限将变得越来越清晰。
为了进行高质量的 CPR,首先,应该通过过程监测工具来优化频率、深度和暂停时间。其次,不断发展的技术进步为实时测量生理参数提供了机会,这将为个体化 CPR 开辟道路。超声、脑饱和度和呼气末 CO2 在测量 CPR 质量中的作用需要进一步研究,以及影响这些测量参数以改善神经功能预后和存活率的可能方法。