Influencia del índice de masa corporal y la forma física de jóvenes universitarios en la capacidad de realizar compresiones torácicas externas de calidad sobre maniquí / Influence of body mass index and physical fitness on university students’ ability to perform high-quality external chest compressions on a mannequin

Objetivos: 1) Analizar las diferencias por sexo en el porcentaje medio de compresiones torácicas externas (CTE) correctas realizadas sobre maniquí por jóvenes universitarios durante 20 minutos por categorías de índice de masa corporal (IMC), capacidad cardiorrespiratoria (CCR) y fuerza muscular; 2) examinar la asociación del IMC y la forma física con la proporción de CTE correctas; y 3) establecer los puntos de corte óptimos de VO2max y fuerza muscular en brazos para realizar CTE correctas. Método: Estudio cuasi-experimental que incluyó 63 estudiantes universitarios. Se determinaron IMC, CCR y fuerza muscular manual. Tras formación previa, realizaron reanimación cardiopulmonar (RCP) en un maniquí durante 20 minutos. Resultados: Los porcentajes medios de CTE correctas y con profundidad adecuada fueron 77,8 (65,1-90,5) y 86,0 (71,7-94,3) en hombres y 41,2 (32,2-50,1) y 43,7 (24,6-52,9) en mujeres (p ≥ 0,001). Las diferencias por género desaparecieron controlando por edad, IMC, CCR y fuerza muscular. El porcentaje medio de CTE correctas fue significativamente mayor en participantes con normopeso/sobrepeso y CCR y fuerza muscular altas. El IMC, la CCR y la fuerza muscular fueron predictores de una adecuada profundidad de compresiones en los modelos de regresión lineal múltiple controlando por edad y sexo. En las curvas ROC, el área bajo la curva para predecir CTE correctas fue 0,862 para VO2 max y 0,872 para la fuerza muscular (puntos de corte de 44,45 ml/Kg/min y de 30,22 Kg respectivamente). Conclusiones: El género, las características antropométricas y la forma física influyen en la realización de CTE correctas. Ello sugiere que una adecuada forma física aumentará la capacidad de los reanimadores para realizar RCP

Objectives: 1) To compare the mean number of external chest compressions (ECCs) performed by male and female university students working on a mannequin for 20 minutes, analyzed according to body mass index (BMI), aerobic capacity, and muscle strength; 2) to analyze the association between BMI and physical fitness and the percentage of high-quality ECCs; and 3) to establish the optimal peak oxygen consumption (VO2 max) and muscle strength cutoffs for performing high-quality ECCs. Methods: Quasi-experimental study of 63 university students. We measured BMI, aerobic capacity, and hand muscle strength. The subjects were trained in cardiopulmonary resuscitation (CPR) and then performed CPR maneuvers on a mannequin for 20 minutes. Results: A mean (95% confidence interval) of 77.8% (65.1%-90.5%) of the ECCs performed by men were technically correct and 86.0% (71.7%-94.3%) were of adequate depth; women performed a mean of 41.2% (32.2%-50.1%) of the ECCs correctly and 43.7% (24.6%-52.9%) were of adequate depth (P ≥.001). After adjustment for age, BMI, aerobic capacity, and muscle strength however, the differences between men and women were no longer significant. Individuals who were of normal weight or overweight and had superior aerobic capacity and muscle strength achieved higher percentages of high-quality ECCs. BMI, aerobic capacity, and hand muscle strength were predictors of ECCs that reached adequate depth according to multiple linear regression models controlling for age and sex. The area under the receiver operating characteristic curve for predicting percentage of correct ECCs was 0.867 for VO2max and 0.872 for hand muscle strength. The cutoffs were 44.45 mL/kg/min for VO2max and 30.22 kg for hand strength. Conclusions: Gender, anthropometric characteristics, and physical fitness affect the ability to perform high-quality ECCs. Our data suggest that maintaining adequate physical fitness would improve individuals' ability to perform CPR

[Cardiopulmonary resuscitation. Electric stimulation of the heart]. / Reanimación cardiopulmonar. 4. Estimulación eléctrica cardiaca.

Due to the alteration in contractions coordinated and organized by miocardiac fibers, various types of cardiac stimulation have been designed which became acceptable standard clinical procedures starting in 1947 after the first successful electrical defibrilation was carried out on a human heart. This article includes techniques such as precordial fist percussion, repetitive precordial beating on the thorax, synchronized cardioversion, non-synchronized electrical shocks and pacemakers. Electrical therapy is used in the treatment of potentially fatal cardiac arrhythmia, especially for ventricular tachycardia, ventricular fibrilation, complete heart block, and asystolia.

[Cardiopulmonary resuscitation. Support of circulation]. / Reanimación cardiopulmonar. 3. Soporte circulatorio.

Whether the cause is primary or secondary, cardiac arrest requires cardiopulmonary resuscitation techniques in order to avoid brain lesions. Cardiac compressions combined with the control of the air passageway and artificial respiration have made it possible to reverse clinical death status in a patient. In this article, the authors review various proven methods including heart pump, thoracic pump, asynchronous respiration, abdominal contrapulsation, cardiopulmonary resuscitation by means of coughing, MAST, ADC, pneumatic vest, etc. which are currently in use.

[Cardiopulmonary resuscitation. Maintenance of the airways and ventilation]. / Mantenimiento de la vía aérea y ventilación.

Oxygen is absolutely necessary for life; gaseous interchange requires the processes of ventilation, perfusion and diffusion. When these fail, we are headed directly for cardiac and/or respiratory arrest. Various techniques are recommended to provide oxygen; there are techniques to open the air tracts and mechanisms to keep these open: and there are mechanisms to facilitate and/or improve ventilation. There definitely are a wide range of means designed to achieve a good level of oxygenation in our tissues.

[Cardiopulmonary resuscitation. General facts and introduction]. / Reanimación cardiopulmonar. Generalidades e introducción.

Cardiopulmonary Resuscitation consists of the integration of treatment for cardiorespiratory arrest as a set of standardized steps, whose objective is to first substitute, and later restore, spontaneous respiration and circulation. This calls for a sequential development; this implies that there are not a series of actions which for prematureness influences their order, but these should be applied sequentially at the right time. There are different criteria among the recommendations by the ERC (European Resuscitation Council) and the AHA (American Heart Association). At the present time, the International Liaison Committee of Resuscitation (ILCOR) has developed a series of recommendations which tries to eliminate these differences, as well as simplify the number of steps necessary to achieve a greater diffusion of these techniques which will lead to a higher number of persons saved. There are also agreements on the incorporation of some terms so we will more frequently read the term Basic Vital Support instead of Basic Cardiopulmonary Resuscitation or Advanced Vital Support instead of Advanced Cardiopulmonary Resuscitation. This article is the first of a series of four articles on cardiopulmonary Resuscitation. The remaining articles will appear in later editions of our magazine.

[Drugs in cardiopulmonary resuscitation. (I) Administration]. / Fármacos en RCP. (I). Administración.

After their classification and limitation based on their therapeutic measures to their most scientifically contrasted efficiency measures, this article reviews what is written for each pharmaceutical in the recommendations bearing more weight in our field, those of the American Heart Association and those of the European Resuscitation Council. A study is made of the various techniques which can be used in administering these drugs as well as their utility and suitability in the field of resuscitation.

[Quality of life of patients with myocardial ischemia]. / Calidad de vida de los pacientes con cardiopatía isquémica.

In this work we intend to determine the variations produced on the quality of life observed and perceived, in the patients with ischemic cardiopathy (IC) whose severe process was treated in the Intensive Care Unit of the Hospital General of Albacete between January and July 1993. A transversal descriptive study on a population of 117 cases was designed. 19 variables were defined, and a summary number scale was designed to determine the quality of life globally. In the results obtained after correcting the initial scale, as it was excessively discriminatory, we found that 47.7% of the individuals suffer a deterioration of their quality of life observed after suffering an IC, 55.4% remain the same, and 2.9% improve. According to the modifications in the quality of life perceived by the patients and interviewers, 24.3% of the first ones show a deterioration in front of 22.4% perceived by the second ones. To conclude we can say that the suffering of an IC limits considerably many aspects of their quality of life, there is enough discrepancy between the quality of life observed and the one perceived.