IntroductionThe number of interventional procedures, such as transcatheter aortic valve replacements or thoracic endovascular aortic repairs, is on the rise. Intraprocedural cardiac arrest is a rare occurrence during high-risk procedures. Modern hybrid-operating tables may adversely affect chest compression quality due to their flexibility. To investigate this relationship, we analyzed the blood pressure generated during chest compressions at different degrees of table extension and assessed the effect of an additional stabilization bar to secure the table.MethodsA CPR manikin was connected to online blood pressure monitoring on a hybrid operating table. Chest compressions were administered using a mechanical device (at 100 bpm and 80 bpm). Hemodynamic effects were evaluated at various degrees of table extension (0%, 50%, 100% table extension) and with the addition of a stabilization bar.ResultsA greater degree of table extension was associated with lower diastolic blood pressure. The addition of a stabilization bar alleviated this drop in diastolic blood pressure and enabled the generation of higher mean arterial pressures at 50% and 100% table extension during chest compressions.ConclusionThe flexibility of a hybrid operating table adversely impacts the hemodynamic effect of chest compressions. This effect may be mitigated by using a stabilization bar. These results may be relevant for providing further recommendations for CPR guidelines in hybrid OR settings.

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提高介入手术期间心肺复苏的有效性

简介介入手术的数量正在增加，例如经导管主动脉瓣置换术或胸腔主动脉血管内修复术。在高风险手术中，术中心脏骤停很少发生。现代混合手术床由于其灵活性可能会对胸外按压质量产生不利影响。为了研究这种关系，我们分析了不同程度的手术床伸展时胸外按压时产生的血压，并评估了额外的稳定杆固定手术床的效果。方法将心肺复苏模型连接到混合手术台上的在线血压监测。使用机械装置进行胸外按压（100 bpm 和 80 bpm）。在不同程度的工作台延伸（0%、50%、100% 工作台延伸）以及添加稳定杆的情况下评估血流动力学效应。结果 工作台延伸程度越大，舒张压越低。添加稳定杆可以缓解舒张压的下降，并在胸外按压期间床伸展 50% 和 100% 时产生更高的平均动脉压。 结论 混合手术台的灵活性会对胸外按压的血流动力学效果产生不利影响。使用稳定杆可以减轻这种影响。这些结果可能有助于为混合手术室中的心肺复苏指南提供进一步的建议。