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        능동적 가압-감압 심폐소생술

        채장성,강동헌,이광수,권순애,김세경,임근우,박승현,오동렬,이기중,승기배,황주일,박규남,이원재,채규보 대한응급의학회 1994 대한응급의학회지 Vol.5 No.2

        Background : Recent studies have demonstrated improved cardiopulmonary circulation during cardiac arrest with the use of a hand-held suction device(AMBU Cardio Pump) to perform active compression-decompression cardiopulmonary resuscitation in animal. The purpose of this study was to compare active compression-decompression with standard CPR during cardiac arrests in emergency department patients. Design : Patients in cardiac arrest in whom standard advanced cardiac life support failed were randomised to receive 2 minutes of either standard or active compression-decompression (ACD) CPR using hand-held suction device, followed by 2 minutes of the alternate technique. The ACD device was applied midsternum and used to perform CPR according to the guidelines of the American Heart Association : 80 compressions per minute, compression depth of 3.8 to 5cm, 50% duty cycle, and constant-volume ventilation. End-tidal carbon dioxide(ETCO2) concentration and hemodynamic variables were measured. In one case, Transcranial doppler sonography was used to assess cerebral blood flow velocity. Results : Twelve patients were enrolled. The mean ±SD ETCO2 was 8.33±2.72mmHg with standard CPR and 12.42±8.3mmHg with ACD-CPR(P<.001). Systolic arterial pressure with standard CPR was 74.75±11.31mmHg and with ACD-CPR, 88.58±16.91mmHg(P<.005). Diastolic arterial pressure with standard CPR was 2.66±6.14mmHg and with ACD-CPR, 1.16±8.11mmHg(P=NS). Base exess with standard CPR was -11.50±5.37 and with ACD-CPR, -11.42±5.37(P=NS). In one case, mean cerebral blood flow velocity with standard CPR was 25.2cm/sec, with ACD CPR, 30.5cm/sec. Conclusion : ACD-CPR is a simple manual technique that improved cardiopulmonary circulation in 12 patients during cardiac arrests.

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