2020年美国心脏协会心肺复苏和心血管急救指南解读——成人基础/高级生命支持  

Interpretation of the 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care-Adult Basic and Advanced Life Support

作　　者：何亚荣 郑玥 周法庭 姚鹏[1,2] 唐颂龄 褚莉莉 周婷圆 王智渊 蒋臻 谷志寒 刘伯夫 程涛 周亚雄 余海放 曹钰 HE Yarong;ZHENG Yue;ZHOU Fating;YAO Peng;TANG Songling;CHU Lili;ZHOU Tingyuan;WANG Zhiyuan;JIANG Zhen;GU Zhihan;LIU Bofu;CHENG Tao;ZHOU Yaxiong;YU Haifang;CAO Yu(Department of Emergency Medicine/Laboratory of Emergency Medicine,West China Hospital/West China School of Medicine,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Disaster Medical Center,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西临床医学院/华西医院急诊科(急诊医学研究室),成都610041 [2]四川大学灾难医学中心,成都610041

出　　处：《华西医学》2020年第11期1311-1323,共13页West China Medical Journal

基　　金：国家自然科学基金(81772037,81801883);四川大学华西医院1·3·5工程项目(ZYJC18019);四川大学华西医院专职博士后研发基金(2019HXBH096)。

摘　　要：美国心脏协会于2020年10月发表《2020年美国心脏协会心肺复苏和心血管急救指南》。该指南在原有院前院内"双五环"生命链的基础上增加复苏后康复环节,形成"双六环"生命链,并对"双六环"生命链中的重要环节进行更新,主要涉及以下内容:非专业施救者早期开始心肺复苏、肾上腺素的早期使用、实时视听反馈装置的应用、心肺复苏质量的生理监测、双重连续电除颤、静脉通路优先于骨通道、复苏后治疗和神经功能预后评估、复苏后康复、复苏后质量改进、孕妇心脏骤停的救治。该文通过查阅文献、与既往指南推荐内容进行对比,就这些要点进行解读。American Heart Association issued American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care in October 2020.A sixth link,recovery,has been added to both the adult out-of-hospital cardiac arrest chain and in-hospital cardiac arrest chain in this version of the guidelines to emphasize the importance of recovery and survivorship for resuscitation outcomes.Analogous chains of survival have also been developed for adult out-of-hospital cardiac arrest and in-hospital cardiac arrest.The major new and updated recommendations involve the early initiation of cardiopulmonary resuscitation by lay rescuers,early administration of epinephrine,real-time audiovisual feedback,physiologic monitoring of cardiopulmonary resuscitation quality,double sequential defibrillation not supported,intravenous access preferred over intraosseous,post-cardiac arrest care and neuroprognostication,care and support during recovery,debriefings for rescuers,and cardiac arrest in pregnancy.This present review aims to interpret these updates by reviewing the literature and comparing the recommendations in these guidelines with previous ones.

关 键 词：指南 心脏骤停 心肺复苏 复苏质量 肾上腺素 电除颤 

分 类 号：R459.7[医药卫生—急诊医学]