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心肺复苏中股动脉与颈动脉脉搏检查的比较:一项前瞻性观察研究。

Comparison of femoral and carotid arteries in terms of pulse check in cardiopulmonary resuscitation: A prospective observational study.

作者信息

Yılmaz Gökhan, Bol Oğuzhan

机构信息

Department of Emergency Medicine, Kayseri City Hospital, Kayseri, Turkey.

Department of Emergency Medicine, Kayseri City Hospital, Kayseri, Turkey.

出版信息

Resuscitation. 2021 May;162:56-62. doi: 10.1016/j.resuscitation.2021.01.042. Epub 2021 Feb 11.

Abstract

BACKGROUND

There is no gold standard pulse localisation for pulse check in cardiopulmonary resuscitation.

AIM

To compare the femoral and carotid arteries in terms of pulse check in cardiopulmonary resuscitation and recommend the most appropriate pulse localisation in advanced life support guidelines and cardiopulmonary resuscitation training programmes.

MATERIALS AND METHODS

We prospectively conducted the study with patients who developed non-traumatic cardiopulmonary arrest between September 2018 and March 2019. The pulse check team was established and divided into two groups, A and B. Both carotid and femoral arteries were checked simultaneously for pulse by members of groups A and B, with the groups alternating between sites to avoid bias. We used some criteria to make pulse detection more effective. These were ETCO2, rhythm and cardiac ultrasonography.

RESULTS

We evaluated 1289 pulse checks in 102 patients. As a result of the statistical analysis with manual palpations and pulses criteria, which we used to detected the presence of a pulse in CPR, we found that the sensitivity of the carotid artery was significantly higher than that of the femoral artery (p = 0.017), with almost identical specificities.

CONCLUSION

The carotid artery should be recommended as the gold standard localisation for pulse checks in cardiopulmonary resuscitation in CPR training programmes and ACLS guidelines.

摘要

背景

在心肺复苏中进行脉搏检查时,没有用于脉搏定位的金标准。

目的

比较在心肺复苏中检查股动脉和颈动脉进行脉搏检查的情况,并在高级生命支持指南和心肺复苏培训计划中推荐最合适的脉搏定位方法。

材料与方法

我们对2018年9月至2019年3月期间发生非创伤性心脏骤停的患者进行了前瞻性研究。成立了脉搏检查小组并分为A、B两组。A组和B组的成员同时检查颈动脉和股动脉的脉搏,两组在不同部位交替进行检查以避免偏差。我们使用了一些标准以使脉搏检测更有效。这些标准包括呼气末二氧化碳分压、心律和心脏超声检查。

结果

我们评估了102例患者的1289次脉搏检查。通过对用于在心肺复苏中检测脉搏存在的手动触诊和脉搏标准进行统计分析,我们发现颈动脉的敏感性显著高于股动脉(p = 0.017),特异性几乎相同。

结论

在心肺复苏培训计划和高级心血管生命支持指南中,应推荐将颈动脉作为心肺复苏中脉搏检查的金标准定位方法。

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