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Massage cardiaque externe automatisé

Massage cardiaque externe automatisé

  • Enseignement Supérieur en Réanimation
  • Médecin
  • Published:
Réanimation

Résumé

Le massage cardiaque externe reste le paramètre prédominant de toute réanimation cardiopulmonaire. En effet, les recommandations internationales insistent sur la prépondérance de l’hémodynamique par rapport à la ventilation. De plus, de nouvelles indications voient le jour concernant le dernier maillon de la chaîne de survie avec le cœur arrêté, le don d’organes, l’intérêt de la coronarographie et de l’angioplastie primaire très précoce, voire per-massage cardiaque externe. Dans ce cadre, il est difficile de maintenir des compressions thoraciques manuelles efficaces sur une longue durée. De plus, celles-ci sont consommatrices de personnel du fait de l’obligatoire rotation pour limiter la fatigue. Le massage cardiaque automatisé est donc une avancée extrêmement intéressante pour l’arsenal à disposition permettant d’optimiser les options thérapeutiques supplémentaires, à condition d’être mis en place et surveillé par des équipes préalablement bien formées. Cependant, il reste encore des inconnues importantes qu’il faut absolument travailler pour préciser les indications de ce type de massage cardiaque et pour en connaître son efficacité en termes de survie.

Abstract

Chest compression is the important technique used during cardiopulmonary resuscitation. The international guidelines stress on the predominance of hemodynamics with respect to ventilation. Furthermore, new indications are growing regarding the last link of the chain of survival including non-heart-beating donation programs and early percutaneous coronary intervention. Within this framework, manual chest compressions are difficult to be maintained efficiently for a long time and need a turnover of the personnel in order to limit the fatigue. Automated chest compressions allow optimization of the available means to address these additional therapeutic options, on the condition of being installed and supervised by well-trained teams. However, unknown factors persist and should be checked in order to specify the indications of this kind of devices and assess their impact on survival rate.

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Authors and Affiliations

  1. Service des urgences, hôpital Lariboisière, 2, rue Ambroise-Paré, F-75010, Paris, France

    P. Plaisance, N. Segal & C. Fulleda

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  1. P. Plaisance
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  2. N. Segal
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  3. C. Fulleda
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Correspondence to P. Plaisance.

Additional information

Cet article correspond à la conférence faite par l’auteur au congrès de la SRLF 2012 dans la session : Controverses dans l’arrêt cardiaque.

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Plaisance, P., Segal, N. & Fulleda, C. Massage cardiaque externe automatisé. Réanimation 21 (Suppl 2), 384–390 (2012). https://doi.org/10.1007/s13546-011-0428-7

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  • DOI: https://doi.org/10.1007/s13546-011-0428-7

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