EVALUATION OF STANDARD AND ACTIVE COMPRESSION-DECOMPRESSION CPR IN AN ACUTE HUMAN-MODEL OF VENTRICULAR-FIBRILLATION
EVALUATION OF STANDARD AND ACTIVE COMPRESSION-DECOMPRESSION CPR IN AN ACUTE HUMAN-MODEL OF VENTRICULAR-FIBRILLATION
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DOI：
10.1161/01.cir.89.2.684
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发表时间：
1994-02-01
期刊：
影响因子：
37.8
通讯作者：
LURIE, KG
中科院分区：
文献类型：
--
作者：
SHULTZ, JJ;COFFEEN, P;LURIE, KG
背景：人类心肺复苏术(CPR)的机制仍然存在争议，也很难研究。这份报告描述了一种新的人体模型，以评估在室颤(VF)发作后的前1到2分钟内的CPR。在这个模型中，将标准CPR与主动按压减压(ACD)CPR进行了比较，ACD CPR是一种使用手持吸引器来主动按压和主动减压的方法。方法与结果在经静脉导联心脏复律/除颤器植入术中常规诱导室性心动过速的过程中，21例患者在第一次除颤失败后进行心肺复苏，直至抢救成功。按美国心脏协会指南在心肺复苏术中进行按压。对于ACD CPR，减压最大可达-30磅。所有患者均测量了动脉压和右房压。测量了最后13名患者的食道压力、气管内压力或分钟通气量。两种CPR技术的应用都增加了动脉和右心房的压力。在整个CPR周期中，ACD CPR的平均冠脉灌注压(压缩，21.5+/-9.0 mm Hg；减压，21.9+/-8.7 mm Hg)高于标准CPR(压缩，17.9+/-8.2 mm Hg；减压，18.5+/-6.9 mm Hg；P
Background The mechanisms that underlie cardiopulmonary resuscitation (CPR) in humans remain controversial and difficult to study. This report describes a new human model to evaluate CPR during the first 1 to 2 minutes after the onset of ventricular fibrillation (VF). With this model, standard CPR was compared with active compression-decompression (ACD) CPR, a method that uses a handheld suction device to actively compress and actively decompress the chest. Methods and Results During routine inductions of VF as part of a transvenous lead cardioverter/defibrillator implantation procedure, CPR was performed in 21 patients if the first defibrillation shock failed and until a successful rescue shock was delivered. Compressions during CPR were performed according to American Heart Association guidelines. For ACD CPR, decompression was performed with up to -30 lbs. Radial arterial and right atrial pressures were measured in all patients. Esophageal pressures, intratracheal pressures, or minute ventilation was measured in the last 13 patients. Application of both CPR techniques increased arterial and right atrial pressures. The mean coronary perfusion pressure was increased throughout the entire CPR cycle with ACD CPR (compression, 21.5+/-9.0 mmHg; decompression, 21.9+/-8.7 mm Hg) compared with standard CPR (compression, 17.9+/-8.2 mm Hg; decompression, 18.5+/-6.9 mm Hg; P