Section 4: Devices to Assist Circulation
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چکیده
Alternative CPR Techniques Alternative techniques to standard manual CPR have been developed to improve perfusion during CPR. These include interposed abdominal compression (IAC) CPR, highfrequency CPR, active compression-decompression (ACD) CPR, vest CPR, mechanical (piston) CPR, simultaneous ventilation-compression (SVC) CPR, phased thoracicabdominal compression-decompression (PTACD) CPR, and invasive CPR. Each of these approaches has been evaluated initially in animal models and then in patients. For some the data is sufficient to recommend them as alternatives to standard CPR in specific clinical settings as described below. Compared with standard CPR, CPR adjuncts generally require additional personnel, training, or equipment. The added effort may increase forward blood flow during CPR from 20% to 100%—levels that are still significantly less than normal cardiac output. Maximum benefits are reported when adjuncts are begun early in the treatment of cardiac arrest,1 so their use is often limited to in-hospital settings. Adjunctive techniques produce little benefit when started late in a prolonged resuscitative effort or when performed as a last-ditch measure after failed ACLS.2–4 To date no adjunct has been shown to be universally superior to standard manual CPR for prehospital BLS.
منابع مشابه
The National Heart, Lung, and Blood Institute Pediatric Circulatory Support Program.
Options for the circulatory support of pediatric patients under the age of 5 years are currently limited to short-term extracorporeal devices, the use of which is often complicated by infection, bleeding, and thromboembolism. Recognizing this void, the National Heart, Lung, and Blood Institute solicited proposals for the development of novel circulatory support systems for infants and children ...
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