Electrophysiology of Muscle Fatigue in Cardiopulmonary Resuscitation on Manikin Model
Q4 · MedicineImpact Factor · 0.43
AutoresCarlos Cobo-Vázquez, Gemma De Blas, Pablo García-Canas, María del Carmen Gasco-García
Por qué importa
Este estudio investiga la fatiga muscular en reanimadores durante la aplicación de compresiones torácicas continuas en un modelo de maniquí, evaluando el tiempo máximo que un profesional puede mantener la calidad de la reanimación sin comprometer su eficacia por agotamiento muscular. Mediante electromiografía, se midió la actividad eléctrica en músculos de la columna alta y lumbar, identificando que la fatiga se inicia alrededor de los 2 minutos de esfuerzo. Se observó que los profesionales deben ejercer fuerzas compensatorias para mantener la efectividad, lo que podría derivar en posturas inadecuadas, dolor musculoesquelético y lesiones a largo plazo. Aunque se centra en la reanimación cardiopulmonar, los hallazgos sobre la fatiga muscular y la biomecánica del esfuerzo continuado podrían tener implicaciones para los odontólogos, quienes realizan procedimientos prolongados y a menudo en posiciones ergonómicas desfavorables.
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.
