Abstract
Background
The literature related to the rationale of cardiopulmonary resuscitation (CPR) including chest compressions combined with ventilations or compression-only CPR without ventilations is reviewed.
Results
The conclusion is that the evidence in favor of compression-only CPR is of limited level of evidence and does not convincingly support the superiority of compressions without ventilations, nor does it prove its non-inferiority. Theoretical and practical considerations favor continued education in the combined application of chest compressions and ventilations with a compression:ventilation ratio of 30:2.
Conclusion
Compression-only CPR should be recommended only if the rescuer is not willing or able to deliver mouth-to-mouth ventilation or when CPR is instructed by the dispatcher to untrained rescuers by telephone. For all other circumstances, trained rescuers should combine chest compressions with ventilations.
Zusammenfassung
Hintergrund
In dieser Übersicht wird die Literatur ausgewertet, die der Diskussion um die Frage zugrunde liegt, ob die kardiopulmonale Wiederbelebung unter Einsatz von Herzdruckmassage einschließlich Ventilation bzw. mit alleiniger Herzdruckmassage durchgeführt werden sollte.
Ergebnis
Im Ergebnis ist festzustellen, dass die Daten zugunsten der alleinigen Thoraxkompression von begrenzter Aussagefähigkeit sind. Sie belegen weder ausreichend die Überlegenheit der Herzdruckmassage ohne Beatmung, noch schließen sie ihre mögliche Unterlegenheit aus. Theoretische und praktische Überlegungen führen dagegen zur Bevorzugung der kombinierten Anwendung von Thoraxkompressionen und Ventilationen mit einem Kompressions-Ventilations-Verhältnis von 30:2.
Schlussfolgerung
Die alleinige Kompression sollte nur empfohlen werden, wenn der Helfer die Mund-zu-Mund-Beatmung nicht beherrscht oder ablehnt oder im Fall der Telefonanleitung eines untrainierten Helfers bei der Reanimation durch Leitstellenmitarbeiter. In allen anderen Fällen sollten ausgebildete Helfer die Herzdruckmassage mit Beatmungen kombinieren.
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Koster, R. Chest compression-only CPR. Notfall Rettungsmed 15, 482–485 (2012). https://doi.org/10.1007/s10049-011-1566-1
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DOI: https://doi.org/10.1007/s10049-011-1566-1