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首页> 外文期刊>Acute Medicine & Surgery >The mechanism of blood flow during chest compressions for cardiac arrest is probably influenced by the patient's chest configuration
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The mechanism of blood flow during chest compressions for cardiac arrest is probably influenced by the patient's chest configuration

机译：胸部按压导致心脏骤停时的血流机制可能受患者的胸部构造影响

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Aim Mechanical assist devices are sometimes needed during resuscitation efforts of patients with prolonged cardiac arrest. Two such devices, the AutoPulse and the LUCAS , have different mechanisms of action. We propose that the effectiveness of mechanical assist devices is somewhat dependent on the configuration and compliance of the patient's chest wall. Methods A previous study of patients with out‐of‐hospital cardiac arrest in Arizona reported that survivors were younger and many were observed to have narrow anterior–posterior chest diameters. These observations suggest that the predominant mechanism of blood flow during cardiopulmonary resuscitation of individuals with primary cardiac arrest is influenced by the patient's anterior–posterior chest diameter and compliance. It is proposed that in older individuals with an increased anterior–posterior chest diameter and decreased chest compliance that the AutoPulse, which works by increasing intrathoracic pressures, may be more effective. In contrast, the LUCAS device, which works predominately by compression of the sternum, is probably more effective in patients with narrower anterior–posterior diameters and a more compliant chest. Results These hypotheses need to be confirmed by researchers who not only have access to the lateral chest roentgenograms of patients with cardiac arrest, to determine their anterior–posterior chest diameter, but also to the type of mechanical device that was used during resuscitation efforts and their patient's survival. If the observations herein proposed are confirmed, hospitals and paramedics may ideally need to have one of each type of mechanical chest compression unit and select the one to use depending on the patient's age and anterior–posterior chest diameter. Conclusions The mechanism of blood flow in patients with cardiac arrest is predominantly secondary to cardiac compression in younger patients with narrow anterior chest diameters and predominately secondary to the thoracic pump mechanism in older patients with emphysema. The mechanism of blood flow in patients with cardiac arrest is predominantly secondary to cardiac compression in younger patients with narrow anterior chest diameters and and predominately secondary to the thoracic pump mechanism in older patients with emphysema.
机译：目的在心脏骤停患者进行复苏时，有时需要机械辅助设备。 AutoPulse和LUCAS这两种设备具有不同的作用机理。我们建议机械辅助设备的有效性在某种程度上取决于患者胸壁的配置和顺应性。方法先前在亚利桑那州进行的院外心脏骤停患者的研究报告说，幸存者较年轻，观察到的许多患者的前后胸径均较窄。这些观察结果表明，原发性心脏骤停患者进行心肺复苏时的主要血流机制受患者的前后胸径和顺应性影响。有人提出，在前胸后径增加且胸顺应性降低的老年人中，通过增加胸腔内压力起作用的AutoPulse可能更有效。相比之下，LUCAS装置主要通过压缩胸骨而起作用，在前后直径较窄且胸部较顺应的患者中可能更有效。结果这些假设需要得到研究人员的证实，研究人员不仅可以获取心脏骤停患者的侧方胸部X线照片，以确定其前后胸径，还可以了解进行复苏工作时使用的机械装置的类型及其患者的生存。如果本文建议的观察结果得到证实，理想情况下，医院和护理人员可能需要使用每种机械式胸部按压装置中的一种，并根据患者的年龄和前后胸部直径选择使用的一种。结论在前胸狭窄的年轻患者中，心脏骤停患者的血流机制主要是继发于心脏压迫，而在老年肺气肿患者中，其血流机制主要次于胸泵机制。心脏骤停患者的血流机制主要发生在前胸狭窄狭窄的年轻患者的心脏压迫继发，而老年肺气肿患者则主要在胸泵机制继发。

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