咳嗽心肺复苏:机制、临床应用及局限性
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摘要
<正>咳嗽心肺复苏(cough cardiopulmonary resuscitation,CCPR或Cough-CPR、Cough-induced CPR),最早由Criley等[1]于1976年提出。Criley等指导在心脏导管室中突发室颤的3例患者,通过有节奏地用力咳嗽,维持意识清醒达24～39 s,并使平均动脉压达到了(139.7±3.8)mm Hg(1 mmHg=0.133 kPa)。咳嗽心肺复苏的提出,为突发室颤的患者提供了自我救
Cough cardiopulmonary resuscitation(Cough-CPR) is used to maintain consciousness for the implementation of advanced life support by rhythmic and vigorous coughing when patients suffer from some arrhythmias causing low or no perfusion for body,such as cardiac arrest,ventricular flutter,ventricular fibrillation,bradycardia with hypotension,ventricular tachycardia.The mechanism of Cough-CPR includes two phrases,"cough systole"and"cough diastole".Cough-CPR has some limitations.It is only applicable in cardiac catheterization,ICU or other conditions with ECG monitor.Besides,arrhythmia must be recognized immediately.More basic and clinical experiments are needed for further research to demonstrate and improve it.
Cough cardiopulmonary resuscitation(Cough-CPR) is used to maintain consciousness for the implementation of advanced life support by rhythmic and vigorous coughing when patients suffer from some arrhythmias causing low or no perfusion for body,such as cardiac arrest,ventricular flutter,ventricular fibrillation,bradycardia with hypotension,ventricular tachycardia.The mechanism of Cough-CPR includes two phrases,"cough systole"and"cough diastole".Cough-CPR has some limitations.It is only applicable in cardiac catheterization,ICU or other conditions with ECG monitor.Besides,arrhythmia must be recognized immediately.More basic and clinical experiments are needed for further research to demonstrate and improve it.
引文
[1] Criley JM,Blaufuss AH ,Kissel GL.Cough-induced cardiac compression.Self-administered from of cardiopulmonary resuscitation[J].JAMA,1976,236(11):1246-1250.
[2] Niemann JT,Rosborough J,Hausknecht M,et al.Cough-CPR:documentation of systemic perfusion in man and in an experimental model:a "window" to the mechanism of blood flow in external CPR[J].Crit Care Med,1980,8(3):141-146.
[3] Ross BB,Gramiak R,Rahn H.Physical dynamics of the cough mechanism[J].Appl Physiol,1955,8(3):264-268.
[4] LoMauro A,Aliverti A.Blood Shift During Cough:Negligible or Significant?[J].Front Physiol,2018,9:501.
[5] Aliverti A,Bovio D,Fullin I,et al.The abdominal circulatory pump[J].PLoS One,2009,4(5):e5550.
[6] Rieser MJ.The use of cough-CPR in patients with acute myocardial infarction[J].Emerg Med,1992,10(3):291-293.
[7] Mitton M.Paroxysmal atrioventricular block in a healthy patient receiving spinal anesthesia:a case report[J].AANA,1993,61(6):605-609.
[8] Miller B,Lesnefsky E,Heyborne T,et al.Cough-cardiopulmonary resuscitation in the cardiac catheterization laboratory:hemodynamics during an episode of prolonged hypotensive ventricular tachycardia[J].Cathet Cardiovasc Diagn,1989,18(3):168-171.
[2] Niemann JT,Rosborough J,Hausknecht M,et al.Cough-CPR:documentation of systemic perfusion in man and in an experimental model:a "window" to the mechanism of blood flow in external CPR[J].Crit Care Med,1980,8(3):141-146.
[3] Ross BB,Gramiak R,Rahn H.Physical dynamics of the cough mechanism[J].Appl Physiol,1955,8(3):264-268.
[4] LoMauro A,Aliverti A.Blood Shift During Cough:Negligible or Significant?[J].Front Physiol,2018,9:501.
[5] Aliverti A,Bovio D,Fullin I,et al.The abdominal circulatory pump[J].PLoS One,2009,4(5):e5550.
[6] Rieser MJ.The use of cough-CPR in patients with acute myocardial infarction[J].Emerg Med,1992,10(3):291-293.
[7] Mitton M.Paroxysmal atrioventricular block in a healthy patient receiving spinal anesthesia:a case report[J].AANA,1993,61(6):605-609.
[8] Miller B,Lesnefsky E,Heyborne T,et al.Cough-cardiopulmonary resuscitation in the cardiac catheterization laboratory:hemodynamics during an episode of prolonged hypotensive ventricular tachycardia[J].Cathet Cardiovasc Diagn,1989,18(3):168-171.