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心率变异性能否预测并改善小儿心肺复苏的效果?一项模拟研究。

Does heart rate variability predict and improve performance in pediatric CPR?-a simulation study.

作者信息

Kula Yosef, Wacht Oren, Ben Shlomo Izhar, Gitler Asaf, Gidron Yori

机构信息

Department of Nursing, Faculty of Social Welfare and Health Sciences University of Haifa, 199 Abba Khoushy Ave. Mount Carmel, POB: 3338, Haifa, Israel.

Department of Emergency Medicine, Faculty of Health Sciences, Ben Gurion University of the Negev, David Ben-Gurion Blvd. 1, P.O B 653, Beer-Sheva, 8410501, Israel.

出版信息

BMC Emerg Med. 2025 Apr 5;25(1):52. doi: 10.1186/s12873-025-01209-9.

Abstract

INTRODUCTION

Out-of-hospital pediatric resuscitation is a severe medical condition with a low survival rate. Providing pediatric resuscitation is a significant stressor for medical teams that may impair performance. The vagal nerve is a crucial moderator of stress responses, and its activation (indexed by heart rate variability, HRV) has been shown to predict and improve performance in various settings. However, there is limited data about vagal activation and performance in medical settings.

METHODS

In a randomized simulation Study, paramedic students and medics were assigned to 3 min of slow-paced breathing or watching an educational 3-minute video. The participant received a scenario describing an unconscious baby without a pulse and with no breathing. The participants then performed CPR (cardiopulmonary resuscitation) on a manikin. During the scenario, every 2 min, the participant was asked a question that tested the recall of information from the scenario, and CPR performance was continuously monitored. HRV and subjective stress were taken 3 times.

RESULTS

Higher baseline HRV predicted better CPR performance. No difference in CPR performance between the groups was found, and explanations for these results will be discussed.

CONCLUSION

HRV may be used to predict CPR performance. Short-term slow-paced breathing does not improve CPR performance. Future studies should investigate the effect of long-term stress reduction interventions on CPR performance.

摘要

引言

院外儿科复苏是一种严重的医疗状况,存活率较低。实施儿科复苏对医疗团队来说是一个重大的压力源,可能会影响其表现。迷走神经是应激反应的关键调节者,其激活(以心率变异性,即HRV为指标)已被证明在各种情况下都能预测并改善表现。然而,关于医疗环境中迷走神经激活与表现的数据有限。

方法

在一项随机模拟研究中,护理专业学生和医护人员被分配进行3分钟的慢节奏呼吸或观看一段3分钟的教育视频。参与者收到一个场景描述,是一个没有脉搏且没有呼吸的昏迷婴儿。然后参与者在人体模型上进行心肺复苏(CPR)。在场景中,每2分钟,会问参与者一个测试其对场景信息回忆的问题,并持续监测CPR表现。HRV和主观压力测量3次。

结果

较高的基线HRV预测了更好的CPR表现。未发现两组之间CPR表现有差异,将对这些结果的解释进行讨论。

结论

HRV可用于预测CPR表现。短期慢节奏呼吸并不能改善CPR表现。未来的研究应调查长期减压干预对CPR表现的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f94e/11972514/027c2ec2c01e/12873_2025_1209_Fig1_HTML.jpg

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