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首页> 外文期刊>Resuscitation. >Increased chest compression to ventilation ratio improves delivery of CPR.
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Increased chest compression to ventilation ratio improves delivery of CPR.

机译：增加的胸部按压与通气比率可改善CPR的递送。

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OBJECTIVE: Chest compressions are interrupted during cardiopulmonary resuscitation (CPR) due to human error, for ventilation, for rhythm analysis and for rescue shocks. Earlier data suggest that the recommended 15:2 compression to ventilation (C:V) ratio results in frequent interruptions of compressions during CPR. We evaluated a protocol change from the recommended C:V ratio of 15:2-30:2 during CPR in our municipal emergency medical system. METHODS: Municipal firefighters (N=875) from a single city received didactic and practical training emphasizing the importance of continuous chest compressions and recommending a 30:2 C:V ratio. Both before and after the training, digital ECG and voice records from all first-responder cases of out-of-hospital cardiac arrest were examined off-line to quantify chest compressions. The number of chest compressions delivered and the number and duration of pauses in chest compressions were compared by t-test for the first three 1min intervals when CPR was recommended. RESULTS: More compressions were delivered during minutes 1, 2, and 3 during CPR with the 30:2 C:V ratio (78+/-29, 80+/-30, 74+/-26) than with the 15:2C:V ratio (53+/-24, 57+/-24, 51+/-26) (p<0.001). Fewer pauses for ventilation occurred during each minute with the 30:2 C:V ratio (1.7+/-1.2, 2.2+/-1.2, 1.8+/-1.0) than with the 15:2C:V ratio (3.4+/-2.6, 4.7+/-7.2, 4.0+/-2.9) (p< or =0.01). Degradation of the final ECG to asystole occurred less frequently after the protocol change (asystole pre 67.1%, post 56.8%, p<0.05). The incidence of return of spontaneous circulation was not altered following the protocol change. CONCLUSIONS: Retraining first responders to use a C:V ratio of 30:2 instead of the traditional 15:2 during out-of-hospital cardiac arrest increased the number of compressions delivered per minute and decreased the number of pauses for ventilation. These data are new as they produced persistent and quantifiable changes in practitioner behavior during actual resuscitations.
机译：目的：在心肺复苏（CPR）过程中，由于人为失误，通风，心律分析和抢救电击导致胸部按压受阻。较早的数据表明，推荐的15：2压缩与通气（C：V）比率会导致CPR期间频繁中断压缩。在我们的城市急诊医疗系统中，我们评估了心肺复苏期间推荐的C：V比为15：2-30：2的方案变更。方法：来自单个城市的市政消防员（N = 875）接受了教学和实践培训，强调持续胸部按压的重要性，并建议C：V比为30：2。在培训前后，对所有院外心脏骤停急救病例的数字ECG和语音记录进行离线检查，以量化胸部按压。在推荐进行CPR的前三个1分钟间隔内，通过t检验比较了分娩的胸部按压次数，胸部按压的暂停次数和持续时间。结果：C：V比为30：2（78 +/- 29、80 +/- 30、74 +/- 26）的心肺复苏术在第1、2和3分钟内传递的压缩力比15：2C更多：V比（53 +/- 24、57 +/- 24、51 +/- 26）（p <0.001）。以30：2的C：V比（1.7 +/- 1.2、2.2 +/- 1.2、1.8 +/- 1.0）在每分钟内发生的通风暂停次数少于以15：2C：V的比率（3.4 +/-） 2.6、4.7 +/- 7.2、4.0 +/- 2.9）（p <或= 0.01）。改变方案后，最终心电图降解为心搏停止的频率更低（心搏停止前为67.1％，后为56.8％，p <0.05）。方案更改后，自发循环恢复的发生率未改变。结论：对急救人员进行再培训，使其在院外心脏骤停期间使用30：2的C：V比率，而不是传统的15：2，增加了每分钟传递的压缩次数，并减少了通气暂停的次数。这些数据是新的，因为它们在实际复苏过程中在执业者行为方面产生了持续且可量化的变化。

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