СПОСОБЫ КОМПРЕССИИ ГРУДНОЙ КЛЕТКИ ПРИ МОДЕЛИРОВАНИИ РЕАНИМАЦИИ ПАЦИЕНТОВ С COVID-19: РАНДОМИЗИРОВАННОЕ ПЕРЕКРЕСТНОЕ ИМИТАЦИОННОЕ ИССЛЕДОВАНИЕ
Аннотация
Введение: Качественное сжатие грудной клетки - один из ключевых элементов реанимации для восстановления спонтанного кровообращения. В эпоху COVID-19 медицинский персонал должен носить средства индивидуальной защиты (СИЗ) от процедур, генерирующих аэрозоль (ПГА) во время реанимации. Однако использование этого средства индивидуальной защиты может снизить эффективность выполняемых медицинских процедур. Цель: сравнить параметры качества компрессии грудной клетки между стандартной ручной компрессией грудной клетки и компрессией грудной клетки с устройством обратной связи TrueCPR, выполняемой студентами-медиками, носящими СИЗ от ПГА. Методы: проведено рандомизированное перекрестное имитационное исследование с одинарным слепым методом. Тридцать два студента-медика в СИЗ против ПГА выполнили 2-минутное непрерывное сжатие грудной клетки на симуляторе для взрослых с устройством обратной связи TrueCPR и без него. Результаты: Средняя глубина сжатия грудной клетки с устройством обратной связи TrueCPR и без него варьировала и составила 46 (IQR; 42-53) против 41 (IQR; 36-45) мм (ручное нажатие на грудную клетку против TrueCPR, соответственно). Частота сжатия грудной клетки вручную составляла 117 (IQR; 112-125) компрессий в минуту и была выше, чем с устройством обратной связи TrueCPR – 107 (IQR; 102-115; p = 0,017). Полное расслабление грудной клетки в методике сжатия грудной клетки, описанной в руководстве (без TrueCPR), составило 33 (IQR; 26-42)% и было ниже, чем при сжатии грудной клетки с устройством обратной связи TrueCPR - 58 (IQR; 40-75)% (p = 0,002). Выводы: мы пришли к выводу, что устройство обратной связи TrueCPR улучшает качество компрессий грудной клетки во время имитации реанимации при COVID-19, выполняемой студентами-медиками, носящими СИЗ при ПГА.
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