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极端环境下心肺复苏的替代技术——一项范围综述

Alternative techniques for cardiopulmonary resuscitation in extreme environments - A scoping review.

作者信息

Overbeek Remco, Liebold Felix, Johnson Kolaparambil Varghese Lydia, Adams Niels-Benjamin, Schmitz Jan, Neumann Michael, Dusse Fabian, Stoll Sandra E, Wetsch Wolfgang A, Hinkelbein Jochen

机构信息

Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.

German Society of Aerospace Medicine (DGLRM), 80331 Munich, Germany.

出版信息

Resusc Plus. 2024 Sep 3;20:100762. doi: 10.1016/j.resplu.2024.100762. eCollection 2024 Dec.

DOI:10.1016/j.resplu.2024.100762
PMID:39286061
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11404056/
Abstract

BACKGROUND

Cardiopulmonary resuscitation (CPR) is essential for saving lives during cardiac arrest, but performing CPR in extreme environments poses unique challenges. In scenarios ranging from hypogravity or microgravity to confined spaces like aeroplanes and underwater scenarios, traditional CPR techniques may be inadequate. This scoping review aims to identify alternative chest compression techniques, synthesise current knowledge, and pinpoint research gaps in resuscitation for cardiac arrest in extreme conditions.

METHODS

PubMed and the Cochrane Register of Controlled Trials as well as the website of ResearchGate was searched to identify relevant literature. Studies were eligible for inclusion if they evaluated alternative chest compression techniques, including manual or mixed CPR approaches, whilst assessing feasibility and effectiveness based on compression depth, rate, and/or impact on rescuer effort.

RESULTS

The database search yielded 9499 references. After screening 26 studies covering 6 different extreme environments were included (hypogravity: 2; microgravity: 9, helicopter: 1, aeroplane: 1, confined space: 11; avalanche: 2). 13 alternative chest compression techniques were identified, all of which tested using manikins to simulate cardiac arrest scenarios.

CONCLUSION

To address the unique challenges in extreme environments, novel CPR techniques are emerging. However, evidence supporting their effectiveness remains limited.

摘要

背景

心肺复苏术（CPR）对于在心脏骤停期间挽救生命至关重要，但在极端环境中进行心肺复苏术面临着独特的挑战。在从低重力或微重力到飞机等密闭空间以及水下场景等各种情况下，传统的心肺复苏技术可能并不适用。本范围综述旨在确定替代胸外按压技术，综合当前知识，并找出极端条件下心脏骤停复苏方面的研究空白。

方法

检索了PubMed、Cochrane对照试验注册库以及ResearchGate网站以识别相关文献。如果研究评估了替代胸外按压技术，包括手动或混合心肺复苏方法，同时根据按压深度、速率和/或对施救者努力的影响评估可行性和有效性，则这些研究符合纳入标准。

结果

数据库检索产生了9499条参考文献。在筛选后，纳入了涵盖6种不同极端环境的26项研究（低重力：2项；微重力：9项；直升机：1项；飞机：1项；密闭空间：11项；雪崩：2项）。确定了13种替代胸外按压技术，所有这些技术均使用人体模型进行测试以模拟心脏骤停场景。

结论

为应对极端环境中的独特挑战，新的心肺复苏技术正在涌现。然而，支持其有效性的证据仍然有限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/6ddbfdf2d6e6/gr11.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/99517163a9b2/gr6.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/6ddbfdf2d6e6/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/95bba0276d92/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/d3fcbca86b62/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/aea728fa1419/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/04f9bf2a8fbc/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/7241311b528c/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/99517163a9b2/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/b6e97b550292/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/813bfcb7030b/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/0e82a6ac97fc/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/f5852ce6cf30/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded7/11404056/6ddbfdf2d6e6/gr11.jpg

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本文引用的文献

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"Head Up CPR" Is Not Ready for Widespread Adoption.“抬头心肺复苏术”尚未准备好广泛应用。
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Cardiopulmonary resuscitation during hyperbaric oxygen therapy: a comprehensive review and recommendations for practice.高压氧治疗中的心肺复苏：全面综述及实践建议。
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Effectiveness of CPR in Hypogravity Conditions-A Systematic Review.低重力条件下心肺复苏的有效性——一项系统综述
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Faster time to automated elevation of the head and thorax during cardiopulmonary resuscitation increases the probability of return of spontaneous circulation.在心肺复苏过程中更快地实现头部和胸部自动抬高可增加自主循环恢复的可能性。
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