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首页> 外文期刊>Resuscitation. >Effects of compression depth and pre-shock pauses predict defibrillation failure during cardiac arrest.
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Effects of compression depth and pre-shock pauses predict defibrillation failure during cardiac arrest.

机译：压缩深度和休克前暂停的影响可预测心脏骤停期间的除颤失败。

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BACKGROUND: Cardiopulmonary resuscitation (CPR) and electrical defibrillation are the primary treatment options for ventricular fibrillation (VF). While recent studies have shown that providing CPR prior to defibrillation may improve outcomes, the effects of CPR quality remain unclear. Specifically, the clinical effects of compression depth and pauses in chest compression prior to defibrillation (pre-shock pauses) are unknown. METHODS: A prospective, multi-center, observational study of adult in-hospital and out-of-hospital cardiac resuscitations was conducted between March 2002 and December 2005. An investigational monitor/defibrillator equipped to measure compression characteristics during CPR was used. RESULTS: Data were analyzed from 60 consecutive resuscitations in which a first shock was administered for VF. The primary outcome was first shock success defined as removal of VF for at least 5s following defibrillation. A logistic regression analysis demonstrated that successful defibrillation was associated with shorter pre-shock pauses (adjusted odds ratio 1.86 for every 5s decrease; 95% confidence interval 1.10-3.15) and higher mean compression depth during the 30s of CPR preceding the pre-shock pause (adjusted odds ratio 1.99 for every 5mm increase; 95% confidence interval 1.08-3.66). CONCLUSIONS: The quality of CPR prior to defibrillation directly affects clinical outcomes. Specifically, longer pre-shock pauses and shallow chest compressions are associated with defibrillation failure. Strategies to correct these deficiencies should be developed and consideration should be made to replacing current-generation automated external defibrillators that require long pre-shock pauses for rhythm analysis.
机译：背景：心肺复苏（CPR）和电除颤是心室纤颤（VF）的主要治疗选择。尽管最近的研究表明，在除颤之前进行CPR可能会改善结局，但CPR质量的影响仍不清楚。具体来说，除颤之前的深度按压和胸部按压暂停（临休前）的临床效果尚不清楚。方法：在2002年3月至2005年12月之间进行了一项关于成人住院和院外心脏复苏的前瞻性，多中心，观察性研究。使用了配备了可监测CPR期间压力特性的研究性监护仪/除颤器。结果：分析了连续60次复苏的数据，其中对VF进行了首次电击。主要结果是首次电击成功，定义为除颤后至少5s去除VF。 Logistic回归分析表明，成功的除颤与较短的休克前休克（每5s调整后的优势比1.86; 95％置信区间1.10-3.15）和休克前休克前30s的CPR较高的平均压迫深度有关（每增加5mm，调整的比值比1.99; 95％置信区间1.08-3.66）。结论：除颤前心肺复苏的质量直接影响临床结果。具体而言，较长的休克前休克和浅胸部按压会与除颤失败相关。应制定纠正这些缺陷的策略，并应考虑更换需要长时间电击前暂停以进行心律分析的新一代自动体外除颤器。

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