Tobias J D, Mencio G A, Atwood R, Gurwitz G S
Department of Anesthesiology, Vanderbilt University, Nashville, TN 37232.
J Pediatr Surg. 1994 Dec;29(12):1537-8. doi: 10.1016/0022-3468(94)90208-9.
Cardiopulmonary resuscitation (CPR) occasionally is necessary in the operating-room setting. In such instances, it may be difficult to perform CPR if the patient is in the prone position. Although the supine position is optimal for CPR, it may not be feasible because of the risks of damage to craniospinal structures. The authors present the case of a 12-year-old boy who had cardiac arrest during spinal fusion. Successful CPR was performed with the patient in the prone position, with the use of "reversed precordial compressions," and the patient was resuscitated despite 7 minutes of asystole. Effective cardiac output was maintained and was confirmed by systolic blood pressure readings of 80 to 90 mm Hg on both the arterial catheter waveform and the noninvasive blood pressure cuff, by a waveform and the reading on the pulse oximeter, and by the presence of end-tidal carbon dioxide.
在手术室环境中，偶尔需要进行心肺复苏（CPR）。在这种情况下，如果患者处于俯卧位，可能难以实施心肺复苏。尽管仰卧位是进行心肺复苏的最佳体位，但由于存在损伤颅脊髓结构的风险，仰卧位可能不可行。作者介绍了一名12岁男孩在脊柱融合手术期间发生心脏骤停的病例。通过使用“反向心前区按压”，在患者俯卧位时成功进行了心肺复苏，尽管患者心搏停止7分钟，但仍被复苏成功。通过动脉导管波形和无创血压袖带测得收缩压为80至90毫米汞柱、脉搏血氧饱和度仪的波形和读数以及呼气末二氧化碳的存在，证实维持了有效的心输出量。
