Studies: CPR Without Rescue Breathing OK
Bystanders Who Only Do Chest Compressions Save Nearly as Many, Researchers Find
By Kathleen Doheny
WebMD Health NewsReviewed by Elizabeth Klodas, MD, FACCJuly 28, 2010 -- Bystanders who perform CPR on patients with suspected heart attacks can safely skip the rescue breathing -- typically called mouth-to-mouth resuscitation -- and just perform the chest compressions, according to two new studies.
研究：不進(jìn)行人工呼吸的心肺復(fù)蘇同樣有效
Kathleen Doheny的一項(xiàng)研究發(fā)現(xiàn)：只行胸外按壓的心肺復(fù)蘇術(shù)同樣挽救了近3/4患者的性命（幾乎和傳統(tǒng)心肺復(fù)蘇相同的人數(shù)？）。
此消息由醫(yī)學(xué)博士Elizabeth Klodas先生，F(xiàn)ACC（Fellow of the American College of Cardiology 美國(guó)心臟病學(xué)學(xué)會(huì)）成員，于2010年7月 28 在WebMD Health NewsReviewed中發(fā)表：根據(jù)兩項(xiàng)新的研究，施救的路人對(duì)心臟驟停的患者行心肺復(fù)蘇術(shù)時(shí)可以放心的地略過(guò)傳統(tǒng)的口對(duì)口人工呼吸這一環(huán)節(jié)，僅行胸外按壓術(shù)。
We feel comfortable saying chest compressions alone, when performed by a layperson, will provide at least the benefit that conventional CPR, with rescue breathing, will provide," researcher Thomas D. Rea, MD, medical director for King County, Wash., Medic One, tells WebMD.
研究員Thomas D Rea（醫(yī)學(xué)博士，華盛頓州King County的醫(yī)學(xué)主任，向WebMD提到：當(dāng)我們提到外行人僅行胸外按壓可以起到和傳統(tǒng)的心肺復(fù)蘇術(shù)一樣的效果時(shí)真的挺欣慰的
The suggestion to skip the mouth-to-mouth part of CPR, he emphasizes, does not apply to emergency medical personnel, but only to laypeople who may be able to provide CPR after a suspected heart attack while waiting for professional medical help to arrive.
但是他強(qiáng)調(diào)，有關(guān)略過(guò)口對(duì)口人工呼吸的心肺復(fù)蘇操作，并不適用于專業(yè)的急救醫(yī)務(wù)人員，僅適用于那些外行人員對(duì)懷疑心臟病發(fā)作的患者急救直到專業(yè)的急救醫(yī)務(wù)人員到來(lái)。
Rea's study, along with another head-to-head comparison of the two CPR approaches, is published in the New England Journal of Medicine.
Rea的這項(xiàng)研究和另外一項(xiàng)有關(guān)兩種心肺復(fù)蘇法的對(duì)照研究一起發(fā)表在新英格蘭醫(yī)學(xué)雜志。
We are trying urgently, desperately, to make CPR more accessible to bystanders," Rea says, noting that performing CPR soon after a heart attack can increase the likelihood of survival twofold. Hopefully, he says, the finding that the rescue breathing is not crucial will make the technique simpler and perhaps more palatable for people.
''我們?cè)噲D讓急救更快、更孤注一擲的進(jìn)行，使心肺復(fù)蘇術(shù)更容易有路人執(zhí)行，“Rea指出，沒(méi)有什么比心臟驟停后及時(shí)行心肺復(fù)蘇更能提高患者的的生存率了。他說(shuō)，我非常希望，人工呼吸并不是那么重要的這一發(fā)現(xiàn)可以使急救更加簡(jiǎn)單，更容易讓人們接受
About CPR
CPR was first proposed about 50 years ago, when researchers suggested that external chest compression could provide blood circulation to the brain and heart after a heart attack. The mouth-to-mouth breathing was added later.
關(guān)于心肺復(fù)蘇術(shù)
心肺復(fù)蘇首次提出大約是在50年前，當(dāng)時(shí)研究人員提到心臟病發(fā)作時(shí)胸外按可以促進(jìn)心腦的血流循環(huán)?？趯?duì)口人工呼吸是后來(lái)加上的。
But in recent studies, researchers have focused on whether both components are always crucial. In 2008, the American Heart Association issued an advisory for the public, advocating hands-only CPR for bystanders not trained in CPR with rescue breathing.
但在最近的研究中，研究人員都比較關(guān)注是否這兩種操作都那么至關(guān)重要。 2008年，美國(guó)心臟協(xié)會(huì)向公眾發(fā)出了倡導(dǎo)，倡導(dǎo)那些未行專業(yè)心肺復(fù)蘇（包括人工呼吸操作的）的路人急救時(shí)只行胸外按壓操作
CPR Techniques: The Studies
Rea's team evaluated 1,941 patients who had out-of-hospital heart attacks and were given CPR from bystanders being instructed by emergency dispatchers. Patients were randomly assigned to get either chest compression only or conventional CPR with rescue breathing.
心肺復(fù)蘇技術(shù)：研究
Rea的研究小組評(píng)估了1941患者，這些院外心臟病發(fā)作的患者均被路人施予心肺復(fù)蘇術(shù)，其中施救的路人的操作均受急救中心調(diào)度指揮。這些患者被隨機(jī)的分為兩組，一半被指定單行胸外按壓另一半則行常規(guī)的心肺復(fù)蘇術(shù)。
The researchers looked at the percent in each group that survived to hospital discharge.
研究人員觀察了兩組患者的存活至出院的人數(shù)的百分比。
"We found that survival in the chest compression alone group was 12.5% and survival in the conventional CPR group was 11%," Rea tells WebMD.
“我們發(fā)現(xiàn)，僅行胸外按壓組的存活率為12.5％，行傳統(tǒng)心肺復(fù)蘇操作組存活率為11％，”Rea告訴WebMD。
Rea's study was supported in part by the Medic One Foundation and the Laerdal Foundation for Acute Medicine. In the second study, Swedish researchers evaluated 1,276 patients with suspected out-of-hospital heart attacks, assigning half to conventional CPR and half to compression-only.
Rea的研究受到了Medic One基金會(huì)和挪度基金會(huì)的支助。在另一項(xiàng)研究中，瑞典研究人員評(píng)估了1276例院外心臟病發(fā)作的患者，這些患者中的一半行傳統(tǒng)的心肺復(fù)蘇術(shù)，另一半僅行胸外按壓術(shù)。
The rate of 30-day survival was similar in the groups -- 8.7% of those getting compression-only CPR and 7% of those getting conventional CPR. The Stockholm County Council, SOS Alarm, and the Swedish Heart-Lung Foundation supported the study.
兩組患者30天存活率較相似， 僅行胸外按壓組為 8.7%，傳統(tǒng)心肺復(fù)蘇組為7％。此項(xiàng)研究由斯德哥爾摩郡議會(huì)，SOS Alarm，和瑞典心肺基金會(huì)贊助。
CPR, With and Without Mouth-to-Mouth: Other Views
The two new studies are good news for bystanders, some of whom have been reluctant to do the rescue breathing part of CPR, says Myron L. Weisfeldt, MD, chairman of the department of medicine at Johns Hopkins University School of Medicine, Baltimore, who wrote an editorial to accompany the studies.
Some bystanders worry about the risk of disease transmission in mouth-to-mouth resuscitation, he tells WebMD, although the risk has been shown to be low.
心肺復(fù)蘇術(shù)，需不需要人工呼吸：其他資訊
這兩項(xiàng)新的研究對(duì)于一些勉強(qiáng)行人工呼吸的路人來(lái)說(shuō)算是好消息，Myron L. Weisfeldt,（醫(yī)學(xué)博士，巴爾的摩，約翰霍普金斯大學(xué)醫(yī)學(xué)院系主任）說(shuō)，并就相關(guān)研究此寫了一篇社論。
他提到：雖然口對(duì)口人工呼吸傳播疾病的風(fēng)險(xiǎn)已經(jīng)被證明了極其低，但一些施救者還是相當(dāng)擔(dān)憂的
Based on the new studies, he says, "chest compression alone appears to be just as valuable as chest compression with rescue breathing." The new findings, he says, apply to adults with cardiac arrest.
根據(jù)新的研究，他說(shuō)：“單純胸外按壓的急救和傳統(tǒng)的心肺復(fù)蘇的急救有同樣的價(jià)值。”這些新的發(fā)現(xiàn)，適用于心臟驟停的成年人。
The chest compression component, he suspects, is also easier for most people to perform than the mouth-to-mouth.
與口對(duì)口人工呼吸的操作相比較，胸外按壓的操作對(duì)大多數(shù)人來(lái)說(shuō)更容易一些。
For the consumer, this is important [news]," says Sumeet Chugh, MD, associate director of the Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles. ''Enough data has accumulated to say that bystander CPR positively impacts survival," he tells WebMD. Now, the finding that chest compression alone seems adequate is even better news, he says.
對(duì)人們來(lái)說(shuō)，這是很重要的消息，“ Cedars-Sinai洛杉磯心臟研究所、Cedars - Sinai醫(yī)療中心的副主任Sumeet Chugh,說(shuō)。''已經(jīng)有足夠的數(shù)據(jù)表明，旁觀者積極的行心肺復(fù)蘇術(shù)會(huì)提高患者的生存率。現(xiàn)在，發(fā)現(xiàn)僅胸外按壓的心肺復(fù)蘇術(shù)就足夠了，這甚至是更好的消息，他說(shuō)。
"It is a little awkward to do rescue breathing on someone you don't know," he says.
對(duì)一個(gè)你不認(rèn)識(shí)的人行人工呼吸是有些別扭和尷尬的，”他說(shuō)。
But, he says, those who go to a CPR course should still expect to be taught the rescue breathing technique, he says, as it may be needed in other situations.
但是，他說(shuō)，那些參加行心肺復(fù)蘇訓(xùn)練的人總是期望被指導(dǎo)如何行人工呼吸，因?yàn)檫@種操作很可能在會(huì)在其他情況用到。
