"CPR"

"CPR"

1. According to the American Heart Association (AHA), “high quality CPR is the cornerstone of a system of care that can optimize outcomes beyond return of spontaneous circulation.”

   • Cardiopulmonary resuscitation (CPR) and defibrillation, if indicated, are the central interventions in the initial resuscitation from sudden cardiac arrest (SCA)
     • Chest compressions, however, are often given either too slow or too fast or include inappropriate pressure on the chest during relaxation.
       • Poor compression quality can significantly affect perfusion and contributes to poor outcome
       • Chest compression rates have been shown to correlate with return of spontaneous circulation (ROSC), survival to discharge, and survival with favorable neurologic outcomes.
         • The ILCOR CoSTR recommendation states:We recommend a manual chest compression rate of 100 to 120/min (strong recommendation, very-low-quality evidence)
           • The provision of continuous compressions with asynchronous ventilation,12 which showed no statistically significant difference in outcome when compared with conventional CPR.
             • Minimally interrupted cardiac resuscitation (MICR), one strategy of which is called cardiocerebral resuscitation, which consists of an initial series of cycles of uninterrupted chest compressions, passive ventilation, and before andafter rhythm analysis with shock if appropriate
         • When manual CPR is provided by 1 person for more than 2 minutes, the quality deteriorates as the person tires. We recommend a chest compression depth of approximately 5 cm (2 in.) (strong recommendation, low-quality evidence) while avoiding excessive chest compression depths (greater than 6 cm [>2.4 in.] in an average adult) (weak recommendation, low-quality evidence) during manual CPR
           • Several devices currently exist that perform mechanical CPR. The most common devices use either a piston system or compression band system to decrease the volume of the thoracic cavity, pushing blood throughout the body
             • Ventilations are recommended at a rate of 2 breaths every 30 compressions or 12 breaths to 15 breaths/min
             • The term continuous chest compressions most often refers to the initial period of resuscitation, most notably during the first 4 to 6 minutes after loss of pulses. During this initial phase, myocardial and cerebral tissue may be most sensitive to decreased blood flow, and hypoperfusion during this sensitive window will lead to worse outcomes.
     • Cardiac arrest is when the heart malfunctions and suddenly stops beating unexpectedly. Sudden cardiac arrest occurs suddenly and often without warning. It is triggered by an electrical malfunction in the heart that causes an irregular heartbeat (arrhythmia).
     • CPR should only be used if someone is: unconscious and not breathing unconscious and not breathing normally.
   • Referencias
     • 1. X. Guyette F, C. Reynolds J. Cardiac Arrest Resuscitation. Elsilver; 2019.
     • 2. Nordeen C. Manual Versus Mechanical Cardiopulmonary Resuscitation A Case Against the Machine [Internet]. 2016 [cited 29 March 2020]. Available from: http://cardiology.theclinics.com
     • 3. Reed-Schrader E, T. Rivers W. Cardiopulmonary Resuscitation Quality Issues [Internet]. Elsevier; 2019 [cited 29 March 2020]. Available from: http://cardiology.theclinics.com