Departament d'Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Tarragona, Catalunya, Spain.
Departament d'Enginyeria Química, Universitat Rovira i Virgili, Tarragona, Catalunya, Spain.
Int J Numer Method Biomed Eng. 2023 Jul;39(7):e3718. doi: 10.1002/cnm.3718. Epub 2023 May 11.
The effect of the dimensions of the thoracic cage on the resuscitation outcome of cardiopulmonary resuscitation (CPR) maneuvers has long been debated. In this study, the effect of changes in the rib cage dimensions on the achieved compression depth was investigated using finite element simulations. A total of 216 different rib cage geometry models were considered and, in each case, the result of applying different levels of compression force up to 600 N were simulated. The Haller Index of the rib cage is defined as the ratio of the transverse diameter and the antero-posterior diameter. Our results suggest that, with a fixed level of compression force, performing CPR on rib cages having a low Haller Index and/or a larger height leads to compression depths below the average. Alternatively, if a target compression depth is set for CPR, in general a lower compression force would be required for individuals with higher Haller Index and/or lower chest height. In addition, present results indicate that wider chested individuals will experience lower stress levels on their ribs to achieve the required CPR target depth. Moreover, in the present study we propose predictive models, based on anthropometric parameters, for compression depth and rib stress during chest compressions. In particular, the model suggests that in future correlations of empirical CPR data the patients' Haller index and vertical (sagittal) cross-area are the best parameters to be used as independent variables in a fit.
胸廓尺寸对心肺复苏（CPR）操作复苏效果的影响一直存在争议。在这项研究中，使用有限元模拟研究了胸廓尺寸变化对实现的压缩深度的影响。总共考虑了 216 种不同的胸廓几何模型，并且在每种情况下，都模拟了施加不同水平的压缩力（高达 600N）的结果。胸廓的 Haller 指数定义为横径与前后径的比值。我们的结果表明，在固定的压缩力水平下，对 Haller 指数较低和/或胸部高度较大的胸廓进行 CPR 会导致压缩深度低于平均值。或者，如果为 CPR 设置了目标压缩深度，通常情况下，Haller 指数较高和/或胸部较低的人需要较低的压缩力。此外，目前的结果表明，较宽胸的人在达到所需的 CPR 目标深度时，肋骨上的压力水平会更低。此外，在本研究中，我们基于人体测量参数，提出了用于压缩深度和肋骨在胸部按压时的应力的预测模型。特别是，该模型表明，在未来对经验性 CPR 数据的相关性研究中，患者的 Haller 指数和垂直（矢状）横截面积是作为拟合的独立变量的最佳参数。
