Excessive chest compression rate is associated with insufficient compression depth in prehospital cardiac arrest
Excessive chest compression rate is associated with insufficient compression depth in prehospital cardiac arrest
复制标题
DOI：
10.1016/j.resuscitation.2012.07.015
复制
发表时间：
2012-11-01
期刊：
影响因子：
6.5
通讯作者：
Calle, Paul A.
中科院分区：
文献类型：
--
作者：
Monsieurs, Koenraad G.;De Regge, Melissa;Calle, Paul A.
研究背景和目的：胸外按压速率和按压深度之间的关系尚不清楚。为了证实这种关系，我们在院前心脏骤停患者中进行了一项观察性研究。我们假设，更快的压缩与depth.Materials和方法：在接受院前心肺复苏术的医疗保健专业人员，胸外按压率和深度的患者记录使用加速度计（E系列监测除颤器，Zoll，美国）。对速率< 80/min、80-120/min和> 120/min的压迫深度进行比较。压迫深度>0.5 cm的差异被认为具有临床意义。使用混合模型，重复测量胸外按压深度和速率（1级），嵌套在患者（2级）中，按压速率作为深度的连续预测因子和分类预测因子，结果以平均值和标准误（SE）报告。结果和讨论：分析了133例连续患者（213，409次按压）。在所有按压中，2%< 80/min，62%在80和120/min之间，36% > 120/min，36%深度< 4 cm，45%在4和5 cm之间，19% > 5 cm。在133名患者中的77名（58%）中，与速率80-120/min相比，速率> 120/min时观察到统计学显著较低的深度，在133名患者中的40名（30%）中，该差异也具有临床意义。混合模型预测，最深压迫（4.5 cm）发生在86/min的速率下，在较高速率下压迫深度逐渐降低。速率> 145/min将导致深度< 4 cm。速率80-120/min的预测按压深度平均为4.5 cm（SE 0.06），而> 120/min的按压深度为4.1 cm（SE 0.06）（平均差异0.4 cm，P < 0.001）。年龄和性别的病人没有额外的影响depth.Conclusions：这项研究表明，较高的压缩率和较低的压缩深度之间的关联。避免过大的按压速率可能导致足够深度的更多按压。(C)2012爱思唯尔爱尔兰有限公司保留所有权利。
Background and goal of study: The relationship between chest compression rate and compression depth is unknown. In order to characterise this relationship, we performed an observational study in prehospital cardiac arrest patients. We hypothesised that faster compressions are associated with decreased depth.Materials and methods: In patients undergoing prehospital cardiopulmonary resuscitation by health care professionals, chest compression rate and depth were recorded using an accelerometer (E-series monitor-defibrillator, Zoll, USA). Compression depth was compared for rates < 80/min, 80-120/min and > 120/min. A difference in compression depth >0.5 cm was considered clinically significant. Mixed models with repeated measurements of chest compression depth and rate (level 1) nested within patients (level 2) were used with compression rate as a continuous and as a categorical predictor of depth.Results are reported as means and standard error (SE). Results and discussion: One hundred and thirty-three consecutive patients were analysed (213,409 compressions). Of all compressions 2% were < 80/min, 62% between 80 and 120/min and 36% > 120/min, 36% were < 4 cm deep, 45% between 4 and 5 cm, 19% > 5 cm. In 77 out of 133 (58%) patients a statistically significant lower depth was observed for rates > 120/min compared to rates 80-120/min, in 40 out of 133 (30%) this difference was also clinically significant. The mixed models predicted that the deepest compression (4.5 cm) occurred at a rate of 86/min, with progressively lower compression depths at higher rates. Rates > 145/min would result in a depth < 4 cm. Predicted compression depth for rates 80-120/min was on average 4.5 cm (SE 0.06) compared to 4.1 cm (SE 0.06) for compressions > 120/min (mean difference 0.4 cm, P < 0.001). Age and sex of the patient had no additional effect on depth.Conclusions: This study showed an association between higher compression rates and lower compression depths. Avoiding excessive compression rates may lead to more compressions of sufficient depth. (C) 2012 Elsevier Ireland Ltd. All rights reserved.