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2010 心肺复苏指南解读. 浙江省台州医院 林荣海. 心肺复苏的历史. 1958 年美国人 Peter safar 发明了口对口人工呼吸 1960 年 Kouwenhoven 发明了胸外心脏按压,从而奠定了现代心肺复苏的基础 分别于 1966 , 1973 , 1985 , 1992 召开全国性的 CPR 会议; 1983 召开首次儿科 CPR 会议(美国); 2000 年召开首次世界 CPR 和 ECC 大会; 2005 年 1 月 23-30 ,在美国达拉斯召开第二届世界 CPR 和 ECC 会议。

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2010 心肺复苏指南解读

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2010


  • 1958Peter safar

  • 1960Kouwenhoven

  • 1966197319851992CPR1983CPR2000CPRECC2005123-30CPRECC

  • 1974AHA198019861992200020052010199219961998


2010

2005


1100/min100/min

24-5cm5cm

3

4CPRA-B-CC-A-B

5CPR

2010


6PEA

7 ROSC94%~98%

810mmol/L

95s


A-B-C C-A-B

A-B-C C-A-B


  • (VF) (VT)


A-B-C C-A-B


  • A-B-C


  • (AED)


EMS

2010


AED AED

10 AED


5


2005


2005

CPR

ACLS


  • 20102005

    1

    2CPRCPR

    3

    4ALS

    5


2010


2010 30 2

2005.


100

  • 2010 100

  • 2005 100


  • (ROSC) AED


  • 2010 5

  • 2005 4 5


  • 5 4


  • CPR3


  • 5 cm


  • 50%

  • 30


  • BP60mmHg





  • 2010 1

  • 100 6 8 1 8 10


2010


AED

10 10 AED



C-A-B A-B-C 30 2

100 100


4 5 5



(AED)

2010

1. AED

:

2.AED


2010 2005

AED < 3 min


  • 2010 2005

  • AED AED

  • AED AED/


  • AED AED 1 3


  • 3


: 2005

ROSC

120-200 J


AED

AED 1 8

AED

AED

AED

1

AED

AED

2005<1 AED




2010

2005


20102005


2010 (ACLS)

1.

2.

3.

4. (PEA)/


5.

6.

QRS

7.


AHA 2010-CPR guideline


2010 AHA-CPR


  • CPR351mg

  • CPR40U

  • 1mg3mg


  • CPRCPR150300mg

  • 11.5mg/kg


/


CPR

CO2(PETCO2)(SpO2)(tcPO2)


94%FIO2

100% FIO2 , 94%


1./

2.

QRS

3.


4.

1 18% 35%

2ACS


1.

2. /

3. (ACS)

4.

5.


2010AHACPR

, , (>33 )

, , 32~34, 12~24 ,


1.?

()


2. ?

30

3. ?

1224, ?


4. ?

3234

!


/


post-resuscitationMODS

150%24

21-3(MODS)

3

4


16kPa65ml/h

1988ShoemakerCVP

DO2VO2

CVP

SvO2PCO2CODO2VO2

BL


SvO2

SvO2MAP

DO2450550ml/min.m2

VO2120140ml/min.m2

CI2.83.5L/min.m2

DO2600ml/min.m2

VO2170ml/min.m2

CI4.5L/min.m2


BL

BLVO2 BL24BL


(OHCA)

1.

AED

()


2.

()



2010


Thank you


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