模拟成人心脏骤停时单纯胸外按压心肺复苏与标准心肺复苏的氧分压比较——基于人体模型的临床建模
Comparison of partial pressure of oxygen between compression-only CPR and standard CPR in simulated adult cardiac arrest - A manikin-based clinical modelling.
作者信息
Kundra Pankaj, Vinayagam Stalin, Cherian Anusha, Ashokka Balakrishnan
机构信息
Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Department of Anaesthesia, National University of Singapore, Singapore.
出版信息
Indian J Anaesth. 2025 Oct;69(10):1055-1060. doi: 10.4103/ija.ija_495_25. Epub 2025 Sep 5.
BACKGROUND AND AIMS
Compression-only cardiopulmonary resuscitation (CPR) has been shown to be as effective as conventional CPR, and oxygen supplementation during compression-only CPR may be beneficial. The study aimed to compare the arterial oxygen levels achieved while supplementing oxygen through high flow nasal cannula (HFNC) during compression-only CPR and bag-mask ventilation (BMV) during conventional CPR in simulated cardiac arrest scenarios on a high-fidelity simulator.
METHODS
The study included a simulated cardiac arrest created on a human patient simulator (HPS). The simulation included two sets of scenarios. In Simulation A, cardiac arrest was simulated on HPS, and compression-only CPR was provided by AutoPulse, and oxygen supplementation was provided using HFNC. In Simulation B, chest compression was provided by AutoPulse, and BMV was supplemented with oxygen at 15 L/min at a compression-to-ventilation ratio of 30:2. Both simulation scenarios were evaluated for three different starting PaO values: 100 mmHg, 80 mmHg, and 60 mmHg. The change in PaO and PAO values was recorded every minute for 6 minutes. Statistical analysis was conducted using SPSS Statistics (Version 24.0; IBM, Armonk, NY), and < 0.05 was considered statistically significant.
RESULTS
In Simulation A, at a starting PaO of 100 mmHg, there was an increase in the PaO at the 2 minute, which was sustained till the 6 minute. PaO values were persistently higher at all time points as compared to Simulation B ( < 0.001). At a starting PaO of 80 mmHg, there was no change in PaO in Simulation A as compared to a sustained fall in Simulation B ( < 0.001). At the starting PaO of 60 mmHg, a decrease in PaO was observed in both Simulation A and Simulation B ( = 0.57).
CONCLUSION
In a simulated setting, compression-only CPR with HFNC results in better PaO levels compared to conventional CPR with BMV.
背景与目的
仅胸外按压心肺复苏术（CPR）已被证明与传统CPR同样有效，且在仅胸外按压CPR期间补充氧气可能有益。本研究旨在比较在高保真模拟器上模拟心脏骤停场景时，仅胸外按压CPR期间通过高流量鼻导管（HFNC）补充氧气与传统CPR期间通过面罩球囊通气（BMV）所达到的动脉血氧水平。
方法
本研究包括在人体患者模拟器（HPS）上模拟心脏骤停。模拟包括两组场景。在模拟A中，在HPS上模拟心脏骤停，由自动心肺复苏机提供仅胸外按压CPR，并使用HFNC补充氧气。在模拟B中，由自动心肺复苏机进行胸外按压，并以30:2的按压与通气比，以15L/min补充氧气的BMV。两种模拟场景针对三种不同的起始动脉血氧分压（PaO）值进行评估：100mmHg、80mmHg和60mmHg。记录6分钟内每分钟的PaO和肺泡动脉血氧分压差（PAO）值变化。使用SPSS Statistics（版本24.0；IBM，纽约州阿蒙克）进行统计分析，P<0.05被认为具有统计学意义。
结果
在模拟A中，起始PaO为100mmHg时，2分钟时PaO升高，并持续至6分钟。与模拟B相比，所有时间点的PaO值持续更高（P<0.001）。起始PaO为80mmHg时，模拟A中的PaO无变化，而模拟B中持续下降（P<0.001）。起始PaO为60mmHg时，模拟A和模拟B中均观察到PaO下降（P = 0.57）。
结论
在模拟环境中，与使用BMV的传统CPR相比，使用HFNC的仅胸外按压CPR可导致更好的PaO水平。
Zotero 插件