{"title":"机械胸腔挤压装置的并发症频率:利用回顾性数据进行的单中心盲法研究","authors":"Takumi Tsuchida , Takashi Kamiishi , Hiroaki Usubuchi , Akiko Semba , Masaki Takahashi , Asumi Mizugaki , Mariko Hayamizu , Mineji Hayakawa , Takeshi Wada","doi":"10.1016/j.resplu.2024.100786","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><div>Use of mechanical chest compression devices for patients with cardiac arrest is increasing. As cardiopulmonary resuscitation (CPR) guidelines and LUCAS are updated, the evidence requires updating.</div></div><div><h3>Methods</h3><div>This single-center, retrospective study observed adult patients with out-of-hospital cardiac arrest receiving CPR from emergency services. Patients were assigned to LUCAS or manual CPR groups, matched by propensity score, and evaluated through computed tomography images by a radiologist blinded to their data. The primary outcome was complications from chest compressions, and logistic regression was used to analyze their risk factors.</div></div><div><h3>Results</h3><div>Overall, 261 patients were selected and divided into manual and LUCAS groups (n = 69 each). The manual CPR group exhibited higher witnessed cardiac arrest percentages (p = 0.023) and shorter times from scene to emergency department (p = 0.001) and total CPR duration (p = 0.002), versus the LUCAS group. Complication rates showed no significant intergroup differences in overall CPR complications (p = 0.462); however, the LUCAS group reported more hemothorax incidents (p = 0.028), versus the manual group. Logistic regression indicated that female sex (odds ratio [OR] 3.743, 95 % confidence interval [CI] 1.333–10.506), older age (OR 1.089, 95 % CI 1.048–1.132), and longer CPR durations (OR 1.045, 95 % CI 1.006–1.085) significantly correlated with compression complications, whereas LUCAS use did not (OR 0.713, 95 % CI 0.304–1.673).</div></div><div><h3>Conclusion</h3><div>No association was observed between LUCAS use and the overall incidence of chest compression complications in adults with OHCA. LUCAS is associated with more hemothorax cases and longer transport time, versus manual CPR. Evaluating LUCAS’s benefits necessitates multiple perspectives and further research.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"20 ","pages":"Article 100786"},"PeriodicalIF":2.1000,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666520424002376/pdfft?md5=a8b09004911812fab518e99f463098a1&pid=1-s2.0-S2666520424002376-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Complication frequency of mechanical chest compression devices: A single-center, blinded study using retrospective data\",\"authors\":\"Takumi Tsuchida , Takashi Kamiishi , Hiroaki Usubuchi , Akiko Semba , Masaki Takahashi , Asumi Mizugaki , Mariko Hayamizu , Mineji Hayakawa , Takeshi Wada\",\"doi\":\"10.1016/j.resplu.2024.100786\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aim</h3><div>Use of mechanical chest compression devices for patients with cardiac arrest is increasing. As cardiopulmonary resuscitation (CPR) guidelines and LUCAS are updated, the evidence requires updating.</div></div><div><h3>Methods</h3><div>This single-center, retrospective study observed adult patients with out-of-hospital cardiac arrest receiving CPR from emergency services. Patients were assigned to LUCAS or manual CPR groups, matched by propensity score, and evaluated through computed tomography images by a radiologist blinded to their data. The primary outcome was complications from chest compressions, and logistic regression was used to analyze their risk factors.</div></div><div><h3>Results</h3><div>Overall, 261 patients were selected and divided into manual and LUCAS groups (n = 69 each). The manual CPR group exhibited higher witnessed cardiac arrest percentages (p = 0.023) and shorter times from scene to emergency department (p = 0.001) and total CPR duration (p = 0.002), versus the LUCAS group. Complication rates showed no significant intergroup differences in overall CPR complications (p = 0.462); however, the LUCAS group reported more hemothorax incidents (p = 0.028), versus the manual group. Logistic regression indicated that female sex (odds ratio [OR] 3.743, 95 % confidence interval [CI] 1.333–10.506), older age (OR 1.089, 95 % CI 1.048–1.132), and longer CPR durations (OR 1.045, 95 % CI 1.006–1.085) significantly correlated with compression complications, whereas LUCAS use did not (OR 0.713, 95 % CI 0.304–1.673).</div></div><div><h3>Conclusion</h3><div>No association was observed between LUCAS use and the overall incidence of chest compression complications in adults with OHCA. LUCAS is associated with more hemothorax cases and longer transport time, versus manual CPR. Evaluating LUCAS’s benefits necessitates multiple perspectives and further research.</div></div>\",\"PeriodicalId\":94192,\"journal\":{\"name\":\"Resuscitation plus\",\"volume\":\"20 \",\"pages\":\"Article 100786\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-09-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666520424002376/pdfft?md5=a8b09004911812fab518e99f463098a1&pid=1-s2.0-S2666520424002376-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Resuscitation plus\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666520424002376\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Resuscitation plus","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666520424002376","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
目的对心脏骤停患者使用机械胸外按压装置的情况越来越多。随着心肺复苏(CPR)指南和 LUCAS 的更新,证据也需要更新。方法这项单中心回顾性研究观察了在院外接受急救中心心肺复苏的心脏骤停成人患者。患者被分配到 LUCAS 或人工心肺复苏组,根据倾向评分进行配对,并由对患者数据保密的放射科医生通过计算机断层扫描图像进行评估。主要结果是胸外按压引起的并发症,并采用逻辑回归分析其风险因素。结果共选取了 261 名患者,分为手动组和 LUCAS 组(各 69 人)。与 LUCAS 组相比,手动心肺复苏组的目击心脏骤停比例更高(p = 0.023),从现场到急诊科的时间更短(p = 0.001),心肺复苏总持续时间更短(p = 0.002)。并发症发生率显示,在总体心肺复苏并发症方面,组间无明显差异(p = 0.462);但 LUCAS 组报告的血气胸发生率(p = 0.028)高于手动组。逻辑回归表明,女性(几率比 [OR] 3.743,95% 置信区间 [CI] 1.333-10.506)、年龄较大(OR 1.089,95% CI 1.048-1.132)和心肺复苏持续时间较长(OR 1.045,95% CI 1.006-1.085)与按压并发症显著相关。结论 在 OHCA 成人患者中,未观察到 LUCAS 的使用与胸外按压并发症的总体发生率之间存在关联。与手动心肺复苏相比,LUCAS 与更多的血气胸病例和更长的转运时间有关。评估 LUCAS 的益处需要从多个角度进行深入研究。
Complication frequency of mechanical chest compression devices: A single-center, blinded study using retrospective data
Aim
Use of mechanical chest compression devices for patients with cardiac arrest is increasing. As cardiopulmonary resuscitation (CPR) guidelines and LUCAS are updated, the evidence requires updating.
Methods
This single-center, retrospective study observed adult patients with out-of-hospital cardiac arrest receiving CPR from emergency services. Patients were assigned to LUCAS or manual CPR groups, matched by propensity score, and evaluated through computed tomography images by a radiologist blinded to their data. The primary outcome was complications from chest compressions, and logistic regression was used to analyze their risk factors.
Results
Overall, 261 patients were selected and divided into manual and LUCAS groups (n = 69 each). The manual CPR group exhibited higher witnessed cardiac arrest percentages (p = 0.023) and shorter times from scene to emergency department (p = 0.001) and total CPR duration (p = 0.002), versus the LUCAS group. Complication rates showed no significant intergroup differences in overall CPR complications (p = 0.462); however, the LUCAS group reported more hemothorax incidents (p = 0.028), versus the manual group. Logistic regression indicated that female sex (odds ratio [OR] 3.743, 95 % confidence interval [CI] 1.333–10.506), older age (OR 1.089, 95 % CI 1.048–1.132), and longer CPR durations (OR 1.045, 95 % CI 1.006–1.085) significantly correlated with compression complications, whereas LUCAS use did not (OR 0.713, 95 % CI 0.304–1.673).
Conclusion
No association was observed between LUCAS use and the overall incidence of chest compression complications in adults with OHCA. LUCAS is associated with more hemothorax cases and longer transport time, versus manual CPR. Evaluating LUCAS’s benefits necessitates multiple perspectives and further research.