人工呼吸是心脏骤停急救中的累赘

人们常在影视作品中见到这样的场景：某人因心脏骤停而倒下，路人赶紧上前急救，有节律地按压胸部并嘴对嘴人工呼吸。但英国权威医学刊物《柳叶刀》15日刊登一份研究报告说，在这种情况下省去人工呼吸，集中精力按压胸部往往更有效。

这份由奥地利和美国研究人员完成的报告说，他们综合分析了1985年到2010年间关于心脏骤停急救的多项研究。这些研究中包含了大量心脏骤停急救的医疗记录。分析结果显示，与同时按压胸部和人工呼吸相比，只按压胸部的急救成功率要高出约20％。

研究人员说，这是因为在许多心脏骤停案例中，上前急救的只是路人，他们往往没有受过充分的训练，如果花时间在不得法的人工呼吸上，还不如一直进行胸部按压。这样胸部按压造成的血液流动不会因为人工呼吸而中断，心脏复苏效果会更好。（生物谷Bioon.com）

生物谷推荐英文摘要：

The Lancet doi:10.1016/S0140-6736(10)61454-7

Chest-compression-only versus standard cardiopulmonary resuscitation: a meta-analysis
Michael Hüpfl MD a, Harald F Selig MD a, Dr Peter Nagele MD a b

Background

In out-of-hospital cardiac arrest, dispatcher-assistedchest-compression-only bystander CPR might be superior to standardbystander CPR (chest compression plus rescue ventilation), but trialfindings have not shown significantly improved outcomes. We aimed toestablish the association of chest-compression-only CPR with survival inpatients with out-of-hospital cardiac arrest.

Methods

Medline and Embase were systematically reviewed for studies publishedbetween January, 1985, and August, 2010, in whichchest-compression-only bystander CPR was compared with standardbystander CPR for adult patients with out-of-hospital cardiac arrest. Inthe primary meta-analysis, we included trials in which patients wererandomly allocated to receive one of the two CPR techniques, accordingto dispatcher instructions; and in the secondary meta-analysis, weincluded observational cohort studies of chest-compression-only CPR. Allstudies had to supply survival data. The primary outcome was survivalto hospital discharge. A fixed-effects model was used for bothmeta-analyses because of an absence of heterogeneity among the studies(I2=0%).

Findings

In the primary meta-analysis, pooled data from three randomisedtrials showed that chest-compression-only CPR was associated withimproved chance of survival compared with standard CPR (14% [211/1500]vs 12% [178/1531]; risk ratio 1·22, 95% CI 1·01—1·46). The absoluteincrease in survival was 2·4% (95% CI 0·1—4·9), and the number needed totreat was 41 (95% CI 20—1250). In the secondary meta-analysis of sevenobservational cohort studies, no difference was recorded between the twoCPR techniques (8% [223/2731] vs 8% [863/11 152]; risk ratio 0·96, 95%CI 0·83—1·11).

Interpretation

For adults with out-of-hospital cardiac arrest, instructions tobystanders from emergency medical services dispatch should focus onchest-compression-only CPR.