Mechanical adjuncts for cardiocerebral resuscitation
Mechanical adjuncts for cardiocerebral resuscitation
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DOI：
10.1080/17434440.2019.1649135
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发表时间：
2019-08-03
影响因子：
3.1
通讯作者：
Balzer，Claudius
中科院分区：
文献类型：
--
作者：
Riess，Matthias L.;Balzer，Claudius
简介：心脏骤停仍然是一个全球性的健康问题，结局非常差。在没有旁观者复苏的情况下，心跳骤停和全脑缺血每分钟的存活率下降10%。然而，即使是最好的手动胸外按压，也只能产生正常心输出量的一小部分和流向重要器官的血流。在这篇综述文章中重点介绍了使用机械装置提高心脏骤停后生存率和生活质量的生理学原理和现有证据。主动加压减压装置等机械装置，自动胸腔压迫器和负压阀的使用（阻抗阈值设备）可以协同帮助提高心肺复苏质量，增加心输出量和重要器官灌注。专家意见：目前的结论是，在临床前环境中不推荐使用机械辅助器械，或者最多是中性的，需要重新评估，特别是对于新的先进和有前途的治疗，这些治疗需要在运送到医院期间进行长时间的高质量CPR，以改善患者的结局。
Introduction: Cardiac arrest remains a worldwide health problem with very poor outcome. In the absence of bystander resuscitation, survival rates decrease by 10% per minute of arrest and global ischemia. Even the best manual chest compressions, however, can only produce a fraction of normal cardiac output and blood flow to vital organs. Physiological principles and current evidence for the use of mechanical devices to increase survival and quality of life after cardiac arrest are highlighted in this review article.Areas covered: Mechanical adjuncts such as the Active Compression Decompression device, automated chest compressors and the use of a negative pressure valve (Impedance Threshold Device) can synergistically aid in improving quality of CPR and increasing cardiac output and vital organ perfusion.Expert opinion: The current conclusions that the use of mechanical adjunct devices in a preclinical setting is not recommended or neutral at best, need to be reevaluated, especially with regard to new advanced and promising treatments that require prolonged high-quality CPR during the transport to a hospital to improve the outcome of patients.