SAMU 38, Centre Hospitalier Universitaire Grenoble Alpes, 38043, Grenoble, France.
Université de Grenoble-Alpes/CNRS, UMR 5525Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, 38000, Grenoble, France.
Sci Rep. 2023 Nov 21;13(1):20393. doi: 10.1038/s41598-023-47727-z.
Our goal was to investigate the effects of head-thorax elevation (HUP) during chest compressions (CC) on lung ventilation. A prospective study was performed on seven human cadavers. Chest was automatically compressed-decompressed in flat position and during progressive HUP from 18 to 35°. Lung ventilation was measured with electrical impedance tomography. In each cadaver, 5 sequences were randomly performed: one without CC at positive end-expiratory pressure (PEEP) 0cmHO, 3 s with CC at PEEP0, 5 or 10cmHO and 1 with CC and an impedance threshold device at PEEP0cmHO. The minimal-to-maximal change in impedance (VT in arbitrary unit a.u.) and the minimal impedance in every breathing cycle (EELI) the) were compared between flat, 18°, and 35° in each sequence by a mixed-effects model. Values are expressed as median (1st-3rd quartiles). With CC, between flat, 18° and 35° VT decreased at each level of PEEP. It was 12416a.u. (10,689; 14,442), 11,239 (7667; 13,292), and 6457 (4631; 9516), respectively, at PEEP0. The same was true with the impedance threshold device. EELI/VT significantly decreased from - 0.30 (- 0.40; - 0.15) before to - 1.13 (- 1.70; - 0.61) after the CC (P = 0.009). With HUP lung ventilation decreased with CC as compared to flat position. CC are associated with decreased in EELI.
我们的目的是研究在胸部按压（CC）期间头胸抬高（HUP）对肺通气的影响。在七个人体尸体上进行了前瞻性研究。在仰卧位和从 18 度到 35 度的逐步 HUP 过程中，胸部被自动压缩-减压。使用电阻抗断层成像术测量肺通气。在每个尸体中，随机进行了 5 个序列：一个在呼气末正压（PEEP）0cmHO 时没有 CC 的序列，3 个在 PEEP0 时有 CC 的序列，5 个或 10cmHO 时有 CC 的序列，1 个在 PEEP0cmHO 时有 CC 和阻抗阈值装置的序列。通过混合效应模型比较了每个序列在平坦、18°和 35°时的阻抗最小-最大变化（VT 在任意单位 a.u.）和每个呼吸周期的最小阻抗（EELI）。值表示为中位数（1 四分位数-3 四分位数）。在有 CC 的情况下，在每个 PEEP 水平下，从平坦、18°到 35°，VT 都在下降。在 PEEP0 时，分别为 12416a.u.（10,689; 14,442）、11,239（7667; 13,292）和 6457（4631; 9516）。在使用阻抗阈值装置时也是如此。EELI/VT 从 CC 前的 -0.30（-0.40; -0.15）显著下降到 CC 后的 -1.13（-1.70; -0.61）（P = 0.009）。与平坦位置相比，HUP 时的肺通气在 CC 期间下降。CC 与 EELI 的减少有关。
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