Department of emergency medicine, Pusan National University Yansgan Hospital, Pusan National Univerisy School of medicine.
Department of emergency medicine, Pusan National University Yansgan Hospital, Pusan National Univerisy School of medicine.
Am J Emerg Med. 2022 Oct;60:116-120. doi: 10.1016/j.ajem.2022.07.057. Epub 2022 Aug 3.
During manual chest compression, maintaining accurate compression depth and consistency is a challenge. Therefore, mechanical chest compression devices(mCCDs) have been increasingly incorporated in clinical practice. Evaluation and comparison of the efficacy of these devices is critical for extensive clinical application. Hence, this study compared the cardiopulmonary resuscitation(CPR) efficiency of two chest compression devices, LUCAS™ 3(Physio-Control, Redmond, USA) and Easy Pulse (Schiller Medizintechnik GMBH, Feldkirchen, Germany), in terms of blood flow using ultrasonography(USG) in a swine model.
A swine model was used to compare two mCCDs, LUCAS™ 3 and Easy Pulse. Cardiac arrest was induced by injecting potassium chloride(KCl) solution in eight male mongrel pigs and the animals were randomly divided into two groups. Mechanical CPR was provided to two groups using LUCAS™ 3(LUCAS™ 3 group) and Easy Pulse(Easy Pulse group). USG was used to measure hemodynamic parameters including femoral peak systolic velocity(PSV) and femoral artery diameters(diameter during systole and diastole). Blood flow rate was calculated by multiplying the PSV and cross-sectional area of the femoral artery during systole. The end-tidal carbon dioxide(EtCo2), chest compression depth was measured. Systolic blood pressure, mean blood pressure, and diastolic blood pressure were also measured using an arterial catheter.
The chest compression depth was much deeper in LUCAS™ 3 group than Easy Pulse group(LUCAS™ 3: 6.80 cm; Easy Pulse: 3.279 cm, p < 0.001). However, EtCo2 was lower in the LUCAS™ 3 group(LUCAS™ 3: 19.8 mmHg; Easy Pulse: 33.4 mmHg, p < 0.001). The PSV was higher in the LUCAS™ 3 group(LUCAS™ 3: 67.6 cm s; Easy Pulse: 55.0 cm s, p < 0.001), while the systolic(LUCAS™ 3: 1.5 cm; Easy Pulse: 2.0 cm, p < 0.001) and diastolic diameters were larger in the Easy Pulse group(LUCAS™ 3: 0.4; Easy Pulse: 0.8 cm, p < 0.001). The femoral flood flow rate was also lower in the LUCAS™ 3 group(LUCAS™ 3: 32.55 cm/s; Easy Pulse: 61.35 cm/s, p < 0.001).
The Easy Pulse had a shallower compression depth and slower PSV but had a wider systolic diameter in the femoral artery as compared to that in LUCAS™ 3. Blood flow and EtCo2 were higher in the easy pulse group probably because of the wider diameter. Therefore, an easy pulse may create and maintain more effective intrathoracic pressure.
在手动进行胸外按压时，保持准确的按压深度和一致性是一项挑战。因此，机械胸外按压设备（mCCD）已越来越多地应用于临床实践。评估和比较这些设备的疗效对于广泛的临床应用至关重要。因此，本研究通过超声（USG）比较了两种胸外按压设备（美国 Physio-Control 公司的 LUCAS™ 3 和德国 Schiller Medizintechnik GMBH 的 Easy Pulse）在猪模型中的心肺复苏（CPR）效率。
使用猪模型比较了两种 mCCD，LUCAS™ 3 和 Easy Pulse。通过向 8 只雄性杂种猪注射氯化钾（KCl）溶液诱导心脏骤停，然后将动物随机分为两组。使用 LUCAS™ 3（LUCAS™ 3 组）和 Easy Pulse（Easy Pulse 组）对两组进行机械 CPR。使用 USG 测量血流动力学参数，包括股动脉峰值收缩速度（PSV）和股动脉直径（收缩期和舒张期直径）。通过将 PSV 与收缩期股动脉的横截面积相乘来计算血流量。测量呼气末二氧化碳（EtCo2）和胸外按压深度。还使用动脉导管测量收缩压、平均血压和舒张压。
LUCAS™ 3 组的胸外按压深度明显大于 Easy Pulse 组（LUCAS™ 3：6.80cm；Easy Pulse：3.279cm，p<0.001）。然而，LUCAS™ 3 组的 EtCo2 较低（LUCAS™ 3：19.8mmHg；Easy Pulse：33.4mmHg，p<0.001）。LUCAS™ 3 组的 PSV 较高（LUCAS™ 3：67.6cm/s；Easy Pulse：55.0cm/s，p<0.001），而 Easy Pulse 组的收缩期（LUCAS™ 3：1.5cm；Easy Pulse：2.0cm，p<0.001）和舒张期直径较大（LUCAS™ 3：0.4cm；Easy Pulse：0.8cm，p<0.001）。LUCAS™ 3 组的股动脉血流量也较低（LUCAS™ 3：32.55cm/s；Easy Pulse：61.35cm/s，p<0.001）。
与 LUCAS™ 3 相比，Easy Pulse 的按压深度较浅，PSV 较慢，但股动脉的收缩期直径较宽。Easy Pulse 组的血流和 EtCo2 较高，可能是由于直径较宽。因此，Easy Pulse 可能会产生并维持更有效的胸内压力。
