徒手的心肺蘇生と機械的心肺蘇生の比較：ガイドライン2015に基づいて

【目的】2015年の心肺蘇生（cardiopulmonary resuscitation, CPR）ガイドラインでは，胸骨圧迫の速さが100〜120 /min，深さが5〜6 cmと従来よりも厳格な規定となった。我々は新ガイドラインにおける胸骨圧迫は徒手的よりも機械的の方が遵守されると仮定し，当院におけるimmediate cardiac life support（ICLS）コース受講生を対象に評価した。【方法】ICLSコース受講後に徒手的CPRの採点を行った。またLUCAS®2自動心臓マッサージシステム（以下，LUCAS）を用いて機械的CPRの採点も行った。【結果】受講生（n=18）の徒手的C...

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Published in日本集中治療医学会雑誌 Vol. 26; no. 5; pp. 379 - 383
Main Authors 村田, 希吉, 中本, 礼良, 大友, 康裕, 吉行, 綾子, 漆畑, 直
Format Journal Article
LanguageJapanese
Published 一般社団法人 日本集中治療医学会 01.09.2019
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ISSN1340-7988
1882-966X
DOI10.3918/jsicm.26_379

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Abstract 【目的】2015年の心肺蘇生（cardiopulmonary resuscitation, CPR）ガイドラインでは，胸骨圧迫の速さが100〜120 /min，深さが5〜6 cmと従来よりも厳格な規定となった。我々は新ガイドラインにおける胸骨圧迫は徒手的よりも機械的の方が遵守されると仮定し，当院におけるimmediate cardiac life support（ICLS）コース受講生を対象に評価した。【方法】ICLSコース受講後に徒手的CPRの採点を行った。またLUCAS®2自動心臓マッサージシステム（以下，LUCAS）を用いて機械的CPRの採点も行った。【結果】受講生（n=18）の徒手的CPRの結果は深さ3.65〜6.13 cm（中央値5.40 cm），速さ98〜128 /min（中央値115 /min）であり，ばらつきを認めた。一方，LUCASは深さが5.13 cm，速さが101 /minという結果であった。【結論】徒手的CPRではガイドラインからの逸脱を認めた。
AbstractList 【目的】2015年の心肺蘇生（cardiopulmonary resuscitation, CPR）ガイドラインでは，胸骨圧迫の速さが100〜120 /min，深さが5〜6 cmと従来よりも厳格な規定となった。我々は新ガイドラインにおける胸骨圧迫は徒手的よりも機械的の方が遵守されると仮定し，当院におけるimmediate cardiac life support（ICLS）コース受講生を対象に評価した。【方法】ICLSコース受講後に徒手的CPRの採点を行った。またLUCAS®2自動心臓マッサージシステム（以下，LUCAS）を用いて機械的CPRの採点も行った。【結果】受講生（n=18）の徒手的CPRの結果は深さ3.65〜6.13 cm（中央値5.40 cm），速さ98〜128 /min（中央値115 /min）であり，ばらつきを認めた。一方，LUCASは深さが5.13 cm，速さが101 /minという結果であった。【結論】徒手的CPRではガイドラインからの逸脱を認めた。
Author 中本, 礼良
村田, 希吉
吉行, 綾子
大友, 康裕
漆畑, 直
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References 7) Yeung J, Meeks R, Edelson D, et al. The use of CPR feedback/prompt devices during training and CPR performance: A systematic review. Resuscitation 2009;80:743-51.
13) Ji C, Lall R, Quinn T, et al; PARAMEDIC trial Collaborators. Post-admission outcomes of participants in the PARAMEDIC trial: A cluster randomized trial of mechanical or manual chest compressions. Resuscitation 2017;118:82-8.
11) Hayashida K, Tagami T, Fukuda T, et al; SOS-KANTO 2012 Study Group. Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients With Nontraumatic Out-of-Hospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOS-KANTO [Survey of Survivors after Out-of-Hospital Cardiac Arrest in Kanto Area] 2012 Study). J Am Heart Assoc 2017;6.pii:e007420.
18) Spooner BB, Fallaha JF, Kocierz L, et al. An evaluation of objective feedback in basic life support (BLS) training. Resuscitation 2007;73:417-24.
9) Tranberg T, Lassen JF, Kaltoft AK, et al. Quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest before and after introduction of a mechanical chest compression device, LUCAS-2; a prospective, observational study. Scand J Trauma Resusc Emerg Med 2015;23:37.
2) Monsieurs KG, Nolan JP, Bossaert LL, et al; ERC Guidelines 2015 Writing Group. European Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary. Resuscitation 2015;95:1-80.
15) Rubertsson S, Lindgren E, Smekal D, et al. Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the LINC randomized trial. JAMA 2014;311:53-61.
17) Li H, Wang D, Yu Y, et al. Mechanical versus manual chest compressions for cardiac arrest: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med 2016;24:10.
6) Nassar BS, Kerber R. Improving CPR performance. Chest 2017;152:1061-9.
14) Wik L, Olsen JA, Persse D, et al. Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial. Resuscitation 2014;85:741-8.
16) Poole K, Couper K, Smyth MA, et al. Mechanical CPR: Who? When? How?. Crit Care 2018;22:140.
8) Gyory RA, Buchle SE, Rodgers D, et al. The Efficacy of LUCAS in Prehospital Cardiac Arrest Scenarios: A Crossover Mannequin Study. West J Emerg Med 2017;18:437-45.
1) 総務省消防庁．救急救助の現況　I救急編．Available from: https://www.fdma.go.jp/publication/rescue/items/h29_01_kyukyu.pdf
5) 一般社団法人日本蘇生協議会（監）．JRC蘇生ガイドライン2015．東京：医学書院；2016. p. 13-41.
10) Westfall M, Krantz S, Mullin C, et al. Mechanical versus manual chest compressions in out-of-hospital cardiac arrest: a meta-analysis. Crit Care Med 2013;41:1782-9.
4) Neumar RW, Shuster M, Callaway CW, et al. Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015;132 (18 Suppl 2) :S315-67.
3) Perkins GD, Handley AJ, Koster RW, et al; Adult basic life support and automated external defibrillation section Collaborators. European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation 2015;95:81-99.
12) Perkins GD, Lall R, Quinn T, et al; PARAMEDIC trial collaborators. Mechanical versus manual chest compressions for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomized controlled trial. Lancet 2015;385:947-55.
References_xml – reference: 7) Yeung J, Meeks R, Edelson D, et al. The use of CPR feedback/prompt devices during training and CPR performance: A systematic review. Resuscitation 2009;80:743-51.
– reference: 9) Tranberg T, Lassen JF, Kaltoft AK, et al. Quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest before and after introduction of a mechanical chest compression device, LUCAS-2; a prospective, observational study. Scand J Trauma Resusc Emerg Med 2015;23:37.
– reference: 5) 一般社団法人日本蘇生協議会（監）．JRC蘇生ガイドライン2015．東京：医学書院；2016. p. 13-41.
– reference: 16) Poole K, Couper K, Smyth MA, et al. Mechanical CPR: Who? When? How?. Crit Care 2018;22:140.
– reference: 6) Nassar BS, Kerber R. Improving CPR performance. Chest 2017;152:1061-9.
– reference: 10) Westfall M, Krantz S, Mullin C, et al. Mechanical versus manual chest compressions in out-of-hospital cardiac arrest: a meta-analysis. Crit Care Med 2013;41:1782-9.
– reference: 18) Spooner BB, Fallaha JF, Kocierz L, et al. An evaluation of objective feedback in basic life support (BLS) training. Resuscitation 2007;73:417-24.
– reference: 14) Wik L, Olsen JA, Persse D, et al. Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial. Resuscitation 2014;85:741-8.
– reference: 8) Gyory RA, Buchle SE, Rodgers D, et al. The Efficacy of LUCAS in Prehospital Cardiac Arrest Scenarios: A Crossover Mannequin Study. West J Emerg Med 2017;18:437-45.
– reference: 12) Perkins GD, Lall R, Quinn T, et al; PARAMEDIC trial collaborators. Mechanical versus manual chest compressions for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomized controlled trial. Lancet 2015;385:947-55.
– reference: 1) 総務省消防庁．救急救助の現況　I救急編．Available from: https://www.fdma.go.jp/publication/rescue/items/h29_01_kyukyu.pdf
– reference: 3) Perkins GD, Handley AJ, Koster RW, et al; Adult basic life support and automated external defibrillation section Collaborators. European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation 2015;95:81-99.
– reference: 4) Neumar RW, Shuster M, Callaway CW, et al. Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015;132 (18 Suppl 2) :S315-67.
– reference: 15) Rubertsson S, Lindgren E, Smekal D, et al. Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the LINC randomized trial. JAMA 2014;311:53-61.
– reference: 2) Monsieurs KG, Nolan JP, Bossaert LL, et al; ERC Guidelines 2015 Writing Group. European Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary. Resuscitation 2015;95:1-80.
– reference: 13) Ji C, Lall R, Quinn T, et al; PARAMEDIC trial Collaborators. Post-admission outcomes of participants in the PARAMEDIC trial: A cluster randomized trial of mechanical or manual chest compressions. Resuscitation 2017;118:82-8.
– reference: 11) Hayashida K, Tagami T, Fukuda T, et al; SOS-KANTO 2012 Study Group. Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients With Nontraumatic Out-of-Hospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOS-KANTO [Survey of Survivors after Out-of-Hospital Cardiac Arrest in Kanto Area] 2012 Study). J Am Heart Assoc 2017;6.pii:e007420.
– reference: 17) Li H, Wang D, Yu Y, et al. Mechanical versus manual chest compressions for cardiac arrest: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med 2016;24:10.
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Snippet 【目的】2015年の心肺蘇生（cardiopulmonary resuscitation, CPR）ガイドラインでは，胸骨圧迫の速さが100〜120 /min，深さが5〜6...
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Title 徒手的心肺蘇生と機械的心肺蘇生の比較：ガイドライン2015に基づいて
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