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ABSTRACT: HintergrundDas Outcome der kardiopulmonalen Reanimation hängt auch von der Qualität der Thoraxkompression ab. Obwohl die aktuellen Leitlinien
des European Resuscitation Council (ERC) 2005 die technische Entwicklung von Feedback-Systemen fordern, sind bisher keine
zufriedenstellenden Ergebnisse zur Anwendung dieser Systeme in der Literatur zu finden.
Patienten und MethodenBei 60Patienten mit einem Herz-Kreislauf-Stillstand (Alter≥18Jahre) wurden Feedback-gesteuerte kardiopulmonale Reanimationsversuche
unternommen. Die Thoraxkompressionsfrequenz und -tiefe sowie die Zeit ohne Blutfluss für die ersten 9min der kardiopulmonalen
Reanimation wurden ausgewertet und diese mit dem in den ERC-Leitlinien 2005 empfohlenen Ideal verglichen.
ErgebnisseEs konnten keine signifikanten Unterschiede bei den Thoraxkompressionsfrequenzen zum empfohlenen Ideal (100/min) gefunden
werden. Bei der Zeit ohne Blutfluss ergaben sich in den ersten 3min eine Abweichung zum Grenzwert und damit zu lange Pausen
bei den Thoraxkompressionen. In den Minuten 4–9 entsprach die Zeit ohne Blutfluss den Vorgaben der Leitlinien. Die Eindrücktiefe
lag bei 80% der Thoraxkompressionen im Zielbereich von 4–5cm.
SchlussfolgerungenDurch Verwendung eines automatisierten externen Defibrillators (AED) mit Feedback-Technologie gelingt die Einhaltung standardisierter
Thoraxkompressionen nach den ERC-Leitlinien 2005 im professionellen Rettungsdienst. Die Implementierung eines Feedback-Systems
setzt die Schulung des gesamten Rettungsteams voraus.
BackgroundThe outcome of cardiopulmonary resuscitation (CPR) depends on the quality of chest compressions. Current European Resuscitation
Council (ERC) guidelines promote the development of feedback systems. However, no studies presenting satisfactory results
of feedback use have been published.
MethodsA total of 60 patients with cardiac arrest (≥18 years of age) received resuscitation attempts using an automated external
defibrillator (AED) with real-time feedback by the ambulance service of the City of Münster. The frequency of chest compressions,
no-flow time (NFT) and depth of chest compressions were analyzed for the first three cycles of CPR and compared to the ERC
guidelines 2005.
ResultsChest compression frequency did not differ significantly from the ideal as set out in the guidelines. Analysis of NFTs showed
significantly longer NFT for the first cycle but NFT for the second and third cycles did not differ significantly from the
ideal. The target depth of 4-5cm was achieved in 80% of all chest compressions in the first 3 cycles.
ConclusionWith the AED real-time feedback technology used in this study standardized performance of chest compressions could be maintained
in a professional ambulance service. Implementation of a feedback system requires training of ambulance staff.
SchlüsselwörterKardiopulmonale Reanimation-ERC-Leitlinien 2005-Feedback-Automatisierter externer Defibrillator-Zeit ohne Blutfluss
KeywordsCardiopulmonary resuscitation-ERC guidelines 2005-Feedback-Automated external defibrillator-No-flow time
Der Anaesthesist 04/2012; 59(2):135-139. · 0.99 Impact Factor
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[show abstract]
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ABSTRACT: The outcome of cardiopulmonary resuscitation (CPR) depends on the quality of chest compressions. Current European Resuscitation Council (ERC) guidelines promote the development of feedback systems. However, no studies presenting satisfactory results of feedback use have been published.
A total of 60 patients with cardiac arrest (> or =18 years of age) received resuscitation attempts using an automated external defibrillator (AED) with real-time feedback by the ambulance service of the City of Münster. The frequency of chest compressions, no-flow time (NFT) and depth of chest compressions were analyzed for the first three cycles of CPR and compared to the ERC guidelines 2005.
Chest compression frequency did not differ significantly from the ideal as set out in the guidelines. Analysis of NFTs showed significantly longer NFT for the first cycle but NFT for the second and third cycles did not differ significantly from the ideal. The target depth of 4-5 cm was achieved in 80% of all chest compressions in the first 3 cycles.
With the AED real-time feedback technology used in this study standardized performance of chest compressions could be maintained in a professional ambulance service. Implementation of a feedback system requires training of ambulance staff.
Der Anaesthesist 02/2010; 59(2):135-9. · 0.99 Impact Factor
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ABSTRACT: The reported sensitivity of neurovascular ultrasound (nUS) for detecting spontaneous cervical artery dissection (sCAD) varies from 80% to 96% in the internal carotid artery (ICA) and from 70% to 86% in the vertebral arteries (VA). The aim of this study was to assess the sensitivity of nUS compared to MRI of the neck and MR angiography for the detection of sCAD. Forty consecutive patients with sCAD proven by 1.5T MRI were investigated by nUS within 48 hours of admission. A total of 52 cases of sCAD were detected by MRI, equally distributed (n=26, 50%) in the ICA and VA territories. Two sCADs affecting the ICA (n=2, 8%) and two sCADs of the VA (n=2, 8%) had normal initial nUS findings. The sensitivity of nUS in detecting sCAD is high, about 92% for both vascular territories. However, intramural hematomas may be missed either when they are located outside the arterial segments directly visible by nUS or if they are too small to cause hemodynamically significant stenosis.
Journal of Clinical Neuroscience 12/2008; 16(1):79-82. · 1.25 Impact Factor
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ABSTRACT: The reported sensitivity of neurovascular ultrasound (nUS) for detecting spontaneous cervical artery dissection (sCAD) varies from 80% to 96% in the internal carotid artery (ICA) and from 70% to 86% in the vertebral arteries (VA). The aim of this study was to assess the sensitivity of nUS compared to MRI of the neck and MR angiography for the detection of sCAD. Forty consecutive patients with sCAD proven by 1.5 T MRI were investigated by nUS within 48 hours of admission. A total of 52 cases of sCAD were detected by MRI, equally distributed (n = 26, 50%) in the ICA and VA territories. Two sCADs affecting the ICA (n = 2, 8%) and two sCADs of the VA (n = 2, 8%) had normal initial nUS findings. The sensitivity of nUS in detecting sCAD is high, about 92% for both vascular territories. However, intramural hematomas may be missed either when they are located outside the arterial segments directly visible by nUS or if they are too small to cause hemodynamically significant stenosis.
Journal of Clinical Neuroscience.
