Wik L, Mauer D, Robertson C
Department of Research and Education in Acute Medicine, Norwegian Air Ambulance, Drøbak.
Resuscitation. 1995 Dec;30(3):191-202. doi: 10.1016/0300-9572(95)00893-4.
Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) has been evaluated in animal cardiac arrest models and in human outcome studies. Blood flow to the brain and heart is significantly increased during ACD-CPR compared to standard CPR. Transoesophageal Doppler analysis indicates that ACD-CPR increases left ventricular blood volume, velocity of blood flow through the mitral valve (82-140%), and stroke volume (85%). Pressures, such as coronary perfusion-, systolic-, mean-, and diastolic aortic pressures, ETCO2, and tidal volume generated by chest compression and decompression, increase during ACD-CPR compared to standard CPR. Prehospital outcome studies have shown both positive and no extra benefit of ACD-CPR on return of spontaneous circulation, hospital admission, and discharge rates. The ACD-CPR method should be evaluated in patients with witnessed arrest receiving bystander CPR who are found in ventricular fibrillation and do not respond to the three initial DC shocks. There is no evidence that ACD-CPR is worse than standard CPR. Appropriate ACD-CPR training using a standardized curriculum must preceed its implementation. Long-term neurologic outcome studies are needed.
主动压缩-减压心肺复苏术（ACD-CPR）已在动物心脏骤停模型和人体预后研究中得到评估。与标准心肺复苏相比，在进行ACD-CPR期间，流向大脑和心脏的血流量显著增加。经食管多普勒分析表明，ACD-CPR可增加左心室血容量、通过二尖瓣的血流速度（82%-140%）以及每搏输出量（85%）。与标准心肺复苏相比，在进行ACD-CPR期间，诸如冠状动脉灌注压、收缩期主动脉压、平均主动脉压和舒张期主动脉压、呼气末二氧化碳分压以及胸外按压和减压产生的潮气量等压力会升高。院前预后研究表明，ACD-CPR在自主循环恢复、入院率和出院率方面既有积极作用，也没有额外益处。对于在心室颤动中被发现且对最初三次直流电除颤无反应、接受旁观者心肺复苏的目击骤停患者，应评估ACD-CPR方法。没有证据表明ACD-CPR比标准心肺复苏更差。在实施ACD-CPR之前，必须使用标准化课程进行适当的培训。还需要进行长期神经学预后研究。
