Elphinstone Andrew, Laws Samantha
University of London.
Br Paramed J. 2020 Mar 1;4(4):16-24. doi: 10.29045/14784726.2020.12.4.4.16.
Survival rates for patients in out-of-hospital cardiac arrest have remained around 10% in the United Kingdom for the past seven years. If outcomes are to be improved, research into new methods of advanced life support is required. One such method may be 'heads-up' cardiopulmonary resuscitation.
A systematic review of literature exploring heads-up cardiopulmonary resuscitation was conducted in an attempt to identify its effects on survival to discharge and neurological outcome.
A comprehensive search of CINAHL, MEDLINE and Google Scholar was undertaken. Six papers were classed as sufficiently relevant for inclusion. Included studies were generally of low quality and none studied the effect of heads-up cardiopulmonary resuscitation on out-of-hospital cardiac arrest patients. Animal studies identified a significant reduction in intracranial pressure and increase in cerebral and coronary perfusion pressure for use of augmented heads-up cardiopulmonary resuscitation in the porcine model of cardiac arrest.
Further research is required to analyse the effects and potential benefits of augmented heads-up cardiopulmonary resuscitation in out-of-hospital cardiac arrest.
在过去七年中，英国院外心脏骤停患者的生存率一直维持在10%左右。若要改善治疗结果，就需要对新的高级生命支持方法展开研究。“抬头”心肺复苏术可能就是这样一种方法。
对探讨“抬头”心肺复苏术的文献进行了系统综述，以确定其对出院生存率和神经学转归的影响。
全面检索了护理及健康领域数据库（CINAHL）、医学文献数据库（MEDLINE）和谷歌学术。六篇论文被判定为相关性足以纳入研究。纳入的研究质量普遍较低，且均未研究“抬头”心肺复苏术对院外心脏骤停患者的影响。动物研究表明，在猪心脏骤停模型中，使用强化“抬头”心肺复苏术可显著降低颅内压，并提高脑灌注压和冠状动脉灌注压。
需要进一步研究，以分析强化“抬头”心肺复苏术对院外心脏骤停的影响及潜在益处。
