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Electrophysiology of Muscle Fatigue in Cardiopulmonary Resuscitation on Manikin Model.

Abstract

Cardiopulmonary resuscitation requires the provider to adopt positions that could be dangerous for his or her spine, specifically affecting the muscles and ligaments in the lumbar zone and the scapular spinal muscles. Increased fatigue caused by muscular activity during the resuscitation could produce a loss of quality and efficacy, resulting in compromising resuscitation. The aim of this study was to evaluate the maximum time a rescuer can perform uninterrupted chest compressions correctly without muscle fatigue. This pilot study was performed at Universidad Complutense de Madrid (Spain) with the population recruited following CONSORT 2010 guidelines. From the 25 volunteers, a total of 14 students were excluded because of kyphoscoliosis (4), lumbar muscle pain (1), anti-inflammatory treatment (3), or not reaching 80% of effective chest compressions during the test (6). Muscle activity at the high spinal and lumbar (L5) muscles was assessed using electromyography while students performed continuous chest compressions on a ResusciAnne manikin. The data from force exerted were analyzed according to side and muscle groups using Student's t test for paired samples. The influence of time, muscle group, and side was analyzed by multivariate analyses ( p ≤ .05). At 2 minutes, high spinal muscle activity (right: 50.82 ± 9.95; left: 57.27 ± 20.85 μV/ms) reached the highest values. Activity decreased at 5 and 15 minutes. At 2 minutes, L5 activity (right: 45.82 ± 9.09; left: 48.91 ± 10.02 μV/ms) reached the highest values. After 5 minutes and at 15 minutes, activity decreased. Fatigue occurred bilaterally and time was the most important factor. Fatigue began at 2 minutes. Rescuers exert muscular countervailing forces in order to maintain effective compressions. This imbalance of forces could determine the onset of poor posture, musculoskeletal pain, and long-term injuries in the rescuer.

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  • Authors+Show Affiliations

    ,

    Master in Oral Surgery and Implantology, School of Dentistry, Universidad Complutense de Madrid, Spain.

    ,

    Chairman Neurophysiology Service, Ramon y Cajal Hospital, Madrid, Spain.

    ,

    Clinical Assistant Fellow, Ashman Department of Periodontology and Implant Dentistry, College of Dentistry, New York University, New York, New York.

    "Anesthesiology and Resuscitation" Titular Professor, Pharmacology Department, Universidad Complutense de Madrid, Spain.

    Source

    Anesthesia progress 65:1 2018 pg 30-37

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    29509523

    Citation

    TY - JOUR T1 - Electrophysiology of Muscle Fatigue in Cardiopulmonary Resuscitation on Manikin Model. AU - Cobo-Vázquez,Carlos, AU - De Blas,Gemma, AU - García-Canas,Pablo, AU - Del Carmen Gasco-García,María, PY - 2018/09/01/pmc-release PY - 2018/3/7/entrez PY - 2018/3/7/pubmed PY - 2018/3/7/medline KW - Cardiopulmonary resuscitation KW - Electromyography KW - Emergencies KW - High spinal muscles KW - Lumbar muscles KW - Muscular fatigue SP - 30 EP - 37 JF - Anesthesia progress JO - Anesth Prog VL - 65 IS - 1 N2 - Cardiopulmonary resuscitation requires the provider to adopt positions that could be dangerous for his or her spine, specifically affecting the muscles and ligaments in the lumbar zone and the scapular spinal muscles. Increased fatigue caused by muscular activity during the resuscitation could produce a loss of quality and efficacy, resulting in compromising resuscitation. The aim of this study was to evaluate the maximum time a rescuer can perform uninterrupted chest compressions correctly without muscle fatigue. This pilot study was performed at Universidad Complutense de Madrid (Spain) with the population recruited following CONSORT 2010 guidelines. From the 25 volunteers, a total of 14 students were excluded because of kyphoscoliosis (4), lumbar muscle pain (1), anti-inflammatory treatment (3), or not reaching 80% of effective chest compressions during the test (6). Muscle activity at the high spinal and lumbar (L5) muscles was assessed using electromyography while students performed continuous chest compressions on a ResusciAnne manikin. The data from force exerted were analyzed according to side and muscle groups using Student's t test for paired samples. The influence of time, muscle group, and side was analyzed by multivariate analyses ( p ≤ .05). At 2 minutes, high spinal muscle activity (right: 50.82 ± 9.95; left: 57.27 ± 20.85 μV/ms) reached the highest values. Activity decreased at 5 and 15 minutes. At 2 minutes, L5 activity (right: 45.82 ± 9.09; left: 48.91 ± 10.02 μV/ms) reached the highest values. After 5 minutes and at 15 minutes, activity decreased. Fatigue occurred bilaterally and time was the most important factor. Fatigue began at 2 minutes. Rescuers exert muscular countervailing forces in order to maintain effective compressions. This imbalance of forces could determine the onset of poor posture, musculoskeletal pain, and long-term injuries in the rescuer. SN - 1878-7177 UR - https://www.unboundmedicine.com/medline/citation/29509523/Electrophysiology_of_Muscle_Fatigue_in_Cardiopulmonary_Resuscitation_on_Manikin_Model. L2 - http://www.anesthesiaprogress.org/doi/10.2344/anpr-65-01-06?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed ER -