Department of Emergency Medicine, Hennepin Healthcare.
University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Curr Opin Crit Care. 2023 Jun 1;29(3):155-161. doi: 10.1097/MCC.0000000000001037. Epub 2023 Mar 20.
The purpose of this review was to provide an overview of head-up (HUP) CPR physiology, relevant preclinical findings, and recent clinical literature.
Recent preclinical findings have demonstrated optimal hemodynamics and improved neurologically intact survival in animals receiving controlled head and thorax elevation with circulatory adjuncts. These findings are compared with animals in the supine position and/or receiving conventional CPR with the HUP position. There are few clinical studies of HUP CPR. However, recent studies have shown safety and feasibility of HUP CPR and improved near-infrared spectroscopy changes in patients with head and neck elevation. Additional observational studies have shown that HUP CPR performed with head and thorax elevation and circulatory adjuncts has a time-dependent association with survival to hospital discharge, survival with good neurological function, and return of spontaneous circulation.
HUP CPR is a new and novel therapy increasingly used in the prehospital setting and discussed in the resuscitation community. This review provides a relevant review of HUP CPR physiology and preclinical work, and recent clinical findings. Further clinical studies are needed to further explore the potential of HUP CPR.
本文旨在概述头高脚低位（HUP）CPR 的生理学、相关的临床前研究结果和近期的临床文献。
最近的临床前研究发现，接受控制的头胸部抬高和循环辅助治疗的动物具有最佳的血液动力学和提高的神经完整存活率。这些发现与仰卧位的动物和/或接受传统 CPR 的动物进行了比较。HUP CPR 的临床研究较少。然而，最近的研究表明 HUP CPR 的安全性和可行性，以及头颈部抬高时近红外光谱变化的改善。其他观察性研究表明，使用头胸部抬高和循环辅助进行 HUP CPR 与生存至出院、具有良好神经功能的生存和自主循环恢复的时间依赖性相关。
HUP CPR 是一种新的治疗方法，在院外急救环境中越来越多地使用，并在复苏领域进行了讨论。本综述提供了 HUP CPR 生理学和临床前研究结果的相关综述，以及近期的临床研究结果。需要进一步的临床研究来进一步探索 HUP CPR 的潜力。
