Sunde K, Wik L, Steen P A
Ullevål University Hospital, Institute for Experimental Medical Research, Oslo, Norway.
Resuscitation. 1997 Jun;34(3):235-42. doi: 10.1016/s0300-9572(96)01087-8.
The quality of mechanical CPR (M-CPR) was compared with manual standard CPR (S-CPR) and active compression-decompression CPR (ACD-CPR) performed by paramedics on the site of a cardiac arrest and during manual and ambulance transport. Each technique was performed 12 times on manikins using teams from a group of 12 paramedic students with good clinical CPR experience using a random cross-over design. Except for some lost ventilations the CPR effort using the mechanical device adhered to the European Resuscitation Council guidelines, with an added time requirement of median 40 s for attaching the device compared with manual standard CPR. Throughout the study, in comparison with mechanical CPR the quality of CPR with either manual method was significantly worse. In particular, there were considerable individual variations during stretcher transport. With S-CPR and ACD-CPR the median compression times were 38 and 31%, significantly lower than the recommended 50%, and 46-98% of the decompression efforts with ACD-CPR were too weak, particularly during transport on the stairs. With both manual methods, there were no significant differences in the CPR effort between the site of the arrest and the ambulance transport. However, compression rates were reduced and became more erratic during stretcher transport to the ambulance. When walking horizontally, a median of 19% of S-CPR compressions and 84% of ACD-CPR compressions were to weak. On the stairs, 68% of S-CPR compressions and 100% of ACD-CPR compressions were too weak. In conclusion, when evaluated on a manikin, in comparison with manual standard and ACD-CPR, mechanical CPR adhered more closely to ERC guidelines. This was particularly true when performing CPR during transport on a stretcher.
在心脏骤停现场以及手动和救护车转运过程中，对护理人员进行的机械心肺复苏（M-CPR）质量与手动标准心肺复苏（S-CPR）及主动按压-减压心肺复苏（ACD-CPR）的质量进行了比较。采用随机交叉设计，让一组12名具有良好临床心肺复苏经验的护理专业学生组成的团队，在人体模型上对每种技术各进行12次操作。除了一些通气失败情况外，使用机械设备进行的心肺复苏努力符合欧洲复苏委员会的指南，与手动标准心肺复苏相比，连接设备的额外时间要求中位数为40秒。在整个研究过程中，与机械心肺复苏相比，两种手动方法的心肺复苏质量明显较差。特别是在担架转运过程中存在相当大的个体差异。使用S-CPR和ACD-CPR时，按压时间中位数分别为38%和31%，明显低于推荐的50%，并且ACD-CPR减压努力的46%-98%力度过弱，尤其是在楼梯上转运时。对于两种手动方法，在心脏骤停现场和救护车转运期间的心肺复苏努力没有显著差异。然而，在担架转运至救护车期间，按压频率降低且变得更加不稳定。水平行走时，S-CPR按压中有19%、ACD-CPR按压中有84%力度过弱。在楼梯上，S-CPR按压中有68%、ACD-CPR按压中有100%力度过弱。总之，在人体模型上评估时，与手动标准心肺复苏和ACD-CPR相比，机械心肺复苏更符合欧洲复苏委员会的指南。在担架转运过程中进行心肺复苏时尤其如此。
