La compresión torácica sola con reanimación cardiopulmonar se asocia con una mejor supervivencia a largo plazo en comparación con la reanimación cardiopulmonar estándar
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Florence Dumas1, Thomas D Rea, Carol Fahrenbruch
1Emergency Medical Services Division of Public Health for Seattle and King County, Seattle, WA, USA. florence.dumas@cch.aphp.fr
Circulation
|December 12, 2012
Resumen
La resucitación cardiopulmonar asistida por despachador (RCP) con compresiones torácicas solo, en comparación con las compresiones torácicas más la respiración de rescate, está relacionada con una mejor supervivencia a largo plazo para los pacientes con paro cardíaco.
Área de la Ciencia:
- Medicina de emergencia Medicina de emergencia.
- Cardiología Cardiología.
- Salud Pública La salud pública.
Sus antecedentes:
- Existen datos limitados sobre los resultados de supervivencia a largo plazo para la resucitación cardiopulmonar (RCP) de espectadores en entornos comunitarios.
- La efectividad de las estrategias de RCP asistida por despachador (DA-CPR), específicamente las compresiones torácicas solas frente a las compresiones combinadas y las respiraciones de rescate, requiere una investigación adicional para el pronóstico a largo plazo.
Objetivo del estudio:
- Para evaluar los efectos de supervivencia a largo plazo de las instrucciones de RCP asistida por despachador (DA-CPR) que se centran en la compresión torácica sola frente a la compresión torácica más la respiración de rescate.
Principales métodos:
- Estudio de cohorte retrospectivo que combina datos de dos ensayos aleatorizados.
- Estado vital a largo plazo determinado a través de registros de muertes nacionales y estatales hasta el 31 de julio de 2011.
- Análisis de supervivencia utilizando el método Kaplan-Meier y la regresión de Cox.
Principales resultados:
- Se incluyeron 2496 pacientes adultos con paro cardíaco; 1243 recibieron solo compresión torácica, 1253 recibieron compresión torácica más respiración de rescate.
- Se registraron más de 1153,2 años-persona, 2260 muertes y 236 sobrevivientes a largo plazo.
- La compresión torácica por sí sola se asoció con un riesgo de muerte significativamente menor (razón de riesgo ajustada, 0,91; P=0,02).
Conclusiones:
- La instrucción de RCP asistida por despachador con compresión torácica sola demuestra un beneficio de mortalidad a largo plazo.
- Esta estrategia se recomienda sobre la compresión torácica más la respiración de rescate para pacientes adultos con paro cardíaco que requieren asistencia del despachador.
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