除颤技术发展.pptVIP

ERC（欧洲复苏委员会）2005年指南 最新技术可以使得除颤器根据穿过胸廓的电流来控制放电：该技术可增加除颤的成功性 波形——除颤 电流型除颤 ：人们已经接受了除颤是通过电流向心脏的传递来完成的，所以电流型除颤的概念更具魅力。尽管“能量”在传统的术语中已根深 蒂固， 但它毕竟是一个非生理学的描述词…….此概念的优势在于其根据以不同的方式发 出电流形成多种有用的双向波来进行探测…….. 向电流型作为描述词的过渡 只是时间问题并且值得推崇。 Current-Based Defibrillation Because it is accepted that defibrillation is accomplished by the passage of sufficient current through the heart, the concept of current-based defibrillation is appealing. Energy is a nonphysiologic descriptor of defibrillation despite its entrenchment in traditional jargon. Current-based defibrillation has been assessed92,122 but has not yet been used clinically as a better physiologic descriptor of defibrillation dose. This concept merits exploration in light of the variety of biphasic waveforms available that deliver current in different ways. Peak current amplitude, average current, phasic duration, and phasic current flow need to be examined as determinants of shock efficacy. Another difficulty with using energy as a descriptor was described earlier with regard to differences between operator-selected energy and that delivered with the rectilinear biphasic waveform. Transition to current-based description is timely and should be encouraged. AHA（美国心脏学会）2005年指南 * The shock is sent through the chest from defibrillation paddles or disposable adhesive pads (called electrodes) placed on the skin. Preparation of the skin surface and correct placement of electrodes are important factors in a successful outcome. 18 * Correct electrode placement allows more current to pass through the heart. You can see that incorrect placement alters the current pathway and decreases the amount of heart muscle receiving electricity. 20 * A monophasic waveform defibrillator, the standard of care for over the past 40 years, provides a shock with current flow in one direction (from electrode or paddle to the other). * Biphasic defibrillators incorporate two-way current flow in which electrical current flows in one direction, then r