Aim

Prehospital cardiopulmonary resuscitation is performed from scene arrival to hospital arrival. The diverse prehospital resuscitation phases can affect the quality of chest compressions. This study aimed to evaluate the dynamic changes in chest compression quality during prehospital resuscitation.

Methods

Adult out-of-hospital cardiac arrest patients treated without prehospital return of spontaneous circulation were included in Seoul between July 2020 and September 2021. The chest compressions quality was assessed using a real-time chest compression feedback device. The prehospital phase was divided by key events during the prehospital resuscitation timeline (phase 1: first 2 min after initiation of chest compression, phase 2: from the end of phase 1 to 1 min prior to ambulance departure; phase 3: from 1 min before to 1 min after ambulance departure; phase 4: from the end of phase 3 to hospital arrival). The main outcome was no-flow fraction. The no-flow fraction between prehospital phases was compared using repeated-measure analysis of variance.

Results

In total, 788 patients were included. Mean no-flow fraction was the highest in phase 3 (phase 1: 11.3% ± 13.8, phase 2: 19.3% ± 12.3, phase 3: 33.0% ± 34.9, phase 4: 18.7% ± 23.7, p < 0.001). The mean number of total no-flow events per minute was also the highest in phase 3. The minute-by-minute analysis showed that the no-flow fraction rapidly increased before ambulance departure and decreased during ambulance transport.

Conclusion

Dynamic changes in chest compression quality were observed during prehospital resuscitation phase. The no-flow fraction was the highest from 1 min before to 1 min after ambulance departure.

中文翻译：

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院外心脏骤停中从到达现场到救护车运输的院前复苏阶段胸外按压的质量

目的

院前心肺复苏从到达现场到到达医院期间进行。不同的院前复苏阶段会影响胸外按压的质量。本研究旨在评估院前复苏期间胸外按压质量的动态变化。

方法

2020 年 7 月至 2021 年 9 月期间，首尔纳入了未院前恢复自主循环的成人院外心脏骤停患者。使用实时胸部按压反馈装置评估胸部按压质量。院前阶段按院前复苏时间线内的关键事件划分（阶段 1：开始胸外按压后前 2 分钟，阶段 2：从阶段 1 结束到救护车出发前 1 分钟；阶段 3：从胸外按压开始前 1 分钟开始）到救护车出发后 1 分钟；第 4 阶段：从第 3 阶段结束到到达医院）。主要结果是无流量分数。使用重复测量方差分析比较院前阶段之间的无流量分数。

结果

总共包括 788 名患者。平均无流量分数在第 3 阶段最高（第 1 阶段：11.3% ± 13.8，第 2 阶段：19.3% ± 12.3，第 3 阶段：33.0% ± 34.9，第 4 阶段：18.7% ± 23.7，p < 0.001 ）  。每分钟无流量事件的平均数量在第 3 阶段也是最高的。逐分钟分析显示，无流量比例在救护车出发前迅速增加，在救护车运输过程中减少。

结论

院前复苏阶段观察胸外按压质量的动态变化。无流量比例在救护车出发前 1 分钟至救护车出发后 1 分钟内最高。