O processo de ensino-aprendizagem na contemporaneidade deve ser motivo de inquietude pelo avanço da tecnologia e pelo perfil dos nativos digitais. O uso de Tecnologias Educacionais Digitais (TED) deve ser inserido no ensino de Ressuscitação Cardiopulmonar (RCP). A American Heart Association (AHA) incentiva o ensino da RCP em diferentes modalidades. Objetivo: Desenvolver TED - videoaula, vídeo de simulação, e instrumentos de avaliação - teórico e prático, sobre RCP no adulto em Suporte Básico de Vida (SBV), com o uso do Desfibrilador Externo Automático (DEA), no ambiente hospitalar. Metodologia: Trata-se de uma pesquisa aplicada e de produção tecnológica desenvolvida na Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo (EERP/USP). A população foi composta por 16 experts em Urgência e Emergência (UE). Para a avaliação e validação, por meio de instrumentos adaptados, do roteiro/script e storyboard de uma videoaula, roteiro/script e storyboard de um vídeo de simulação, questionário e Exame Clínico Objetivo e Estruturado (OSCE), sobre RCP no adulto em SBV com o uso do DEA em ambiente hospitalar. Para seleção dos expertises foi adotado pontuação mínima de cinco pontos nos critérios de Fehring (1987). Na trajetória metodológica para elaboração dos vídeos foi adotado o modelo proposto por Fleming, Reynolds e Wallace (2009) que consiste em Fase I: Pré-produção, Fase II: Produção e Fase III: Pós-produção. Para elaboração do questionário foi aplicado as regras básicas para elaboração de Questão de Múltipla Escolha (QME) do manual do Conselho Nacional de Examinadores Médicos. O OSCE foi elaborado de acordo com as orientações do Medical Concil of Canadá. As diretrizes da AHA publicadas em 2015 foram a primeira literatura adotada. A pesquisa foi aprovada no Comitê de Ética em Pesquisa (CEP), conforme Resolução 466/2012. Para a apreciação dos dados foi aplicado estatística descritiva e análise de concordância inter-avaliadores por AC1 de Gwet. Categorização da concordância de acordo com Landis e Koch (1997). Os vídeos foram validados em relação ao objetivo, conteúdo, relevância, ambiente, linguagem verbal e inclusão de tópicos. O questionário e OSCE foram validados em relação à organização, objetividade e clareza. Resultados: Os experts são compostos por enfermeiros (100%), predominância do sexo feminino, idade média de 36,56 anos, média de tempo de formação de 12,93 anos, 93,75% com titulação em mestrado, 93,75% com prática clínica em UE no adulto, distribuídos nas regiões Sudeste, Centro-Oeste e Nordeste do Brasil, 62,5% classificados nos critérios de Fehring (1987), com dez ou mais pontos. Todos os itens dos instrumentos de validação registraram predomínio em respostas positivas. Em relação à concordância inter-avaliadores a videoaula foi classificada em \"concordância moderada\", vídeo de simulação em \"concordância considerável\", questionário e OSCE em \"concordância quase perfeita\". A videoaula foi finalizada em 17 minutos e 17 segundos, o vídeo de simulação com 13 minutos e 22 segundos, o questionário com 20 QME e OSCE com 40 itens. Conclusão: O uso de vídeos e a adoção de instrumentos de avaliação adequados no processo de ensinoaprendizagem é um desafio. Por meio da utilização dos objetos validados neste estudo é possível conduzir estratégias de ensino, pesquisa e extensão em contexto contemporâneo e atualizado / The teaching-learning process in the contemporary world must be cause for concern for the advancement of technology and the profile of digital natives. The use of Digital Educational Technologies (DET) should be inserted in the teaching of Cardiopulmonary Resuscitation (CPR). The American Heart Association (AHA) encourages the teaching of CPR in different modalities. Objective: To develop DET - videotape, simulation video, and evaluation instruments - theoretical and practical, on adult CPR in Basic Life Support (BLS), using the Automatic External Defibrillator (AED) in the hospital setting. Methodology: This is an applied research and technological production developed at the Ribeirão Preto Nursing School of the University of São Paulo (EERP / USP). The population was composed of 16 experts in Urgency and Emergency (UE). For the evaluation and validation, through adapted instruments, of the script/screenplay and storyboard of a videotape, script/screenplay and storyboard of a simulation video, questionnaire and Objective and Structured Clinical Examination (OSCE) on adult CPR in BLS with the use of AED in a hospital environment. For selection of the expertises, a minimum score of five points was adopted according to Fehring (1987) criteria. The model proposed by Fleming, Reynolds and Wallace (2009), which consists of Phase I: Pre-production, Phase II: Production and Phase III: Post-production, was adopted. For the preparation of the questionnaire the basic rules for the elaboration of the Multiple Choice Question (MCQ) of the manual of the National Council of Medical Examiners were applied. The OSCE has been developed in accordance with the guidelines of the Medical Council of Canada. The AHA guidelines published in 2015 were the first adopted literature. The research was approved by the Research Ethics Committee (REC), according to Resolution 466/2012. For the evaluation of the data, descriptive statistics and interrater concordance analysis by Gwet\'s AC1 were applied. Categorization of agreement according to Landis and Koch (1997). The videos were validated in relation to the objective, content, relevance, environment, verbal language and inclusion of topics. The questionnaire and OSCE were validated in relation to organization, objectivity and clarity. Results: The experts are composed by nurses (100%), female predominance, mean age of 36.56 years, average training time of 12.93 years, 93.75% with a master\'s degree, 93.75% with clinical practice in the UE in adults, distributed in the Southeast, Midwest and Northeast regions of Brazil, 62.5% classified as Fehring (1987), with ten or more points. All the items of the validation instruments registered a predominance in positive responses. Regarding inter-rater agreement, the videotape was classified as \"moderate agreement\", simulation video in \"considerable agreement\", questionnaire and OSCE in \"nearperfect agreement\". The videotape was finalized in 17 minutes and 17 seconds, the simulation video with 13 minutes and 22 seconds, the questionnaire with 20 MCQ and OSCE with 40 items. Conclusion: The use of videos and the adoption of appropriate assessment tools in the teaching-learning process is a challenge. Through the use of validated objects in this study it is possible to conduct teaching, research and extension strategies in a contemporary and updated context

<p>Ischemic neuronal injury continues to be a major delimiting factor in achieving successful clinical outcomesafter resuscitation from cardiac arrest. In this thesis, a pig model of cardiopulmonary resuscitation (CPR) wasused to address the effects of different interventions on cerebral blood flow and oxygenation during CPR and theinitial postresuscitation period. A novel technique is presented to quantify the reperfusion oxidative injury.</p><p>Maximization of cerebral blood flow during CPR by open-chest cardiac compression, continuous aortic balloon occlusion, and intra-aortic administration of hypertonic saline-dextran (HSD) did not ameliorate thepostresuscitation hypoperfusion or improve the cerebral oxygen extraction ratio or tissue pH. These findings disaffirm earlier studies suggesting that conserving brain viability after global ischemia is mostly a question ofmaintaining high perfusion pressure.</p><p>Despite an increased cerebral perfusion pressure during CPR, intra-aortic administered epinephrineabove the aortic balloon occlusion did not further improve cerebral blood flow and oxygenation. This findingmay indicate adverse effects of epinephrine on cerebral vascular beds, possibly induced by a relatively highconcentration of epinephrine when administered above the site for aortic balloon occlusion.</p><p>The IV administration of equipotent doses of epinephrine or vasopressin during CPR resulted incomparable hemodynamic changes. The peak increase in cerebral cortical blood flow, however, was reachedapproximately 30 sec later by vasopressin. Furthermore, the second bolus of vasopressin during CPR did notaugment cerebral perfusion, whereas epinephrine did. Consequently, reports suggesting that vasopressin issuperior to epinephrine with respect to its effects on central hemodynamics and vital organ blood flow may bebiased by the pharmacodynamic differences between the drugs, depending on the time point at which blood flowmeasurements are performed.</p><p>In comparison with IV vasopressin, vasopressin administered above the aortic balloon occlusion resulted in a significant increase in cerebral perfusion pressure during CPR, but not after restoration of spontaneous circulation (ROSC). Cerebral cortical blood flow was, however, not improved <i>during</i> CPR, whereas a significant increase was recorded <i>after</i> ROSC. Relatively higher concentrations of vasopressin above the sitefor intra-aortic balloon occlusion may, therefore, predominantly induce cerebral cortical vasoconstriction duringCPR but induce vasodilatation after ROSC.</p><p>Assessment of oxidative stress or inflammation have been extremely difficult to attain. In our pig model of resuscitation, an association wasobserved between the duration of cardiac arrest and jugular bulb levels of 8-iso-PGF_2α, a major isoprostane and a novel index of oxidative injury. 8-iso-PGF_2α, and the prostaglandin 15-K-DH-PGF_2α, increased within 5 min after ROSC and remained so up to 2 h, indicating the interval of time during which cerebral reperfusion oxidative injury and inflammatory response may occur and are potentially preventable.</p>

Ischemic neuronal injury continues to be a major delimiting factor in achieving successful clinical outcomesafter resuscitation from cardiac arrest. In this thesis, a pig model of cardiopulmonary resuscitation (CPR) wasused to address the effects of different interventions on cerebral blood flow and oxygenation during CPR and theinitial postresuscitation period. A novel technique is presented to quantify the reperfusion oxidative injury. Maximization of cerebral blood flow during CPR by open-chest cardiac compression, continuous aortic balloon occlusion, and intra-aortic administration of hypertonic saline-dextran (HSD) did not ameliorate thepostresuscitation hypoperfusion or improve the cerebral oxygen extraction ratio or tissue pH. These findings disaffirm earlier studies suggesting that conserving brain viability after global ischemia is mostly a question ofmaintaining high perfusion pressure. Despite an increased cerebral perfusion pressure during CPR, intra-aortic administered epinephrineabove the aortic balloon occlusion did not further improve cerebral blood flow and oxygenation. This findingmay indicate adverse effects of epinephrine on cerebral vascular beds, possibly induced by a relatively highconcentration of epinephrine when administered above the site for aortic balloon occlusion. The IV administration of equipotent doses of epinephrine or vasopressin during CPR resulted incomparable hemodynamic changes. The peak increase in cerebral cortical blood flow, however, was reachedapproximately 30 sec later by vasopressin. Furthermore, the second bolus of vasopressin during CPR did notaugment cerebral perfusion, whereas epinephrine did. Consequently, reports suggesting that vasopressin issuperior to epinephrine with respect to its effects on central hemodynamics and vital organ blood flow may bebiased by the pharmacodynamic differences between the drugs, depending on the time point at which blood flowmeasurements are performed. In comparison with IV vasopressin, vasopressin administered above the aortic balloon occlusion resulted in a significant increase in cerebral perfusion pressure during CPR, but not after restoration of spontaneous circulation (ROSC). Cerebral cortical blood flow was, however, not improved during CPR, whereas a significant increase was recorded after ROSC. Relatively higher concentrations of vasopressin above the sitefor intra-aortic balloon occlusion may, therefore, predominantly induce cerebral cortical vasoconstriction duringCPR but induce vasodilatation after ROSC. Assessment of oxidative stress or inflammation have been extremely difficult to attain. In our pig model of resuscitation, an association wasobserved between the duration of cardiac arrest and jugular bulb levels of 8-iso-PGF2α, a major isoprostane and a novel index of oxidative injury. 8-iso-PGF2α, and the prostaglandin 15-K-DH-PGF2α, increased within 5 min after ROSC and remained so up to 2 h, indicating the interval of time during which cerebral reperfusion oxidative injury and inflammatory response may occur and are potentially preventable.

Det råder delade meningar angående närståendes närvaro under hjärt-lungräddning på sjukhus. Trots internationella riktlinjer från Emergency Nursing Association som säger att närstående bör erbjudas möjlighet att närvara under hjärt- lungräddning så följs ej dessa generellt på sjukhusen. Syftet: Var att beskriva närståendes upplevelser att närvara under hjärt-lungräddning på sjukhus. Metod: En litteraturstudie har gjorts där 13 vetenskapliga artiklar har granskats. Resultat: Närstående ville ha en valmöjlighet om de skulle närvara eller ej. De flesta närstående var nöjda med sitt beslut att närvara och skulle göra det igen trots att situationen upplevdes som svår. Närstående kände samhörighet med patienten och upplevde att de hanterade situationen bättre om de fick kontinuerlig information om händelseförloppet samt hade en stödperson vid sin sida. Sorgen underlättades då de delat den sista stunden med sin närstående. Slutsats: Närståendes närvaro under hjärt-lungräddning är fortfarande ett relativt outforskat område. Valmöjligheten att närvara är viktig, likaså kontinuerlig information och att ha en stödperson hos sig under hjärt-lungräddningen anses väsentligt. Närstående som varit närvarande under hjärt- lungräddning uppvisar lägre tendens till negativa psykologiska effekter och upplever även att sorgeprocessen underlättas. / A difference of opinion exists regarding the issue of relatives being present during cardiopulmonary resuscitation in hospital. Despite international guidelines from the Emergency Nursing Association stating that relatives should be offered the opportunity to be present during cardiopulmonary resuscitation, this is generally not the case. The aim: of this study was to describe relatives' experiences of being present during cardiopulmonary resuscitation in hospital. Method: A literature review in which 13 scientific papers have been reviewed. Results: Relatives preferred to be given the option to attend the cardiopulmonary resuscitation or not. Most relatives were satisfied with their decision to attend and would do it again even though the situation was perceived as difficult. Relatives experienced an emotional connection with the patient and felt that they handled the situation better if they were given continuous information on the events and had a support person at their side. Relatives also felt it easier to cope with the grieving process when they had shared their loved ones last moment. Conclusion: The attendance of relatives during cardiopulmonary resuscitation is still a relatively unexplored area. To be given the option to attend or not is important, as is continuous information during the resuscitation as well as a support person throughout the process. Relatives who were present during resuscitation showed lower tendency to experience negative psychological effects, and that the grieving process felt easier to go through.

Sjuksköterskor har en nära relation till patienter och anhöriga och bör efter bästa förmåga möjliggöra deras delaktighet i vården. Trots att riktlinjer om hjärt-lungräddning (HLR) menar att beslutskompetenta patienter ska vara delaktiga i beslutet om ej-HLR, fungerar det inte alltid så i praktiken. I och med detta kan sjuksköterskor få svårt att hantera situationer som uppstår kring beslutet om ej-HLR. Syftet var att belysa patienters respektive anhörigas delaktighet i beslutet om ej-HLR. Studien genomfördes som en litteraturstudie och 15 vetenskapliga artiklar analyserades. Studiens resultat visar att patienters och anhörigas delaktighet i beslutet om ej-HLR påverkas av olika faktorer så som patienters livskvalité, information om sjukdom, prognos och HLR. Anhöriga vill och får ofta möjlighet att delta i ett beslut om ej-HLR. Anhörigas möjlighet till delaktighet beror främst på patienters beslutskompetens och det är läkare som möjliggör patienters och anhörigas delaktighet i beslutet om ej-HLR. Sjuksköterskors samarbete med läkare i diskussionen om ej-HLR kan underlätta beslutsprocessen för samtliga parter. För att patienters och anhörigas delaktighet ska främjas bör riktlinjerna för beslut angående HLR ses över och möjligen uppdateras. / The nurse has a close relationship with patients and families and should promote the potential of their involvement in care. The medical practice differs from guidelines for cardiopulmonary resuscitation (CPR) which suggests that patients should be involved in the decision making about the do-not-resuscitate (DNR) order. Nurses may find it difficult to deal with situations that arise over the decision about DNR. The aim was to illuminate patients' and relatives' participation in the decision making concerning the DNR order. The study was conducted as a literature study and 15 scientific articles were analyzed. The results show that involvement of patient and next-of-kin in the decision not to resuscitate can be affected by various factors. Factors that could affect patient participation were patients’ quality of life, knowledge about disease, prognosis and CPR. Family members often want and often get the opportunity to participate in the decision making concerning DNR. Relatives' ability to participate depends primarily on patients' ability to participate in the decision making. Doctors enable patients and families participation in the decision not for resuscitation. Nurses’ collaboration with doctors in the discussion about the DNR order can facilitate decision making for all parties. The guidelines for decision about CPR should be reviewed and possibly updated in order to improve patients' and relatives' participation.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Bakgrund: Dödligheten vid hjärtstopp utanför sjukhus är hög och endast några få procent av de som drabbas räddas till livet. Tidig behandling är en avgörande faktor för överlevnad. Överlevnaden kan ökas markant av att människor på platsen, bystanders, ingriper med hjärt-lungräddning (HLR). Att vårda och utföra vårdhandlingar är inte exklusivt för sjuksköterskor. Vid hjärtstopp utanför sjukhus är det istället bystandern som förväntas utföra vårdhandlingen. I många fall sker dock inget ingripande trots att hjärtstoppet bevittnas och den vårdande handlingen uteblir därför. Syfte: Syftet med arbetet var att identifiera faktorer som påverkar människors vilja att ingripa vid hjärtstopp utanför sjukhus. Metod: Arbetet designades som en litteraturstudie där artiklar med både kvantitativ och kvalitativ ansats ingick. Resultat: Resultatet baserades på potentiella bystanders antaganden av hur de skulle agera och faktiska bystanders erfarenheter av att ha agerat. Skillnader i faktorer som påverkade viljan observerades mellan dessa. Viljan påverkades till stor del av rädslor, bristande HLR-kunskaper samt scenariot kring hjärtstoppet där bland annat en familjerelation mellan den drabbade och bystandern utgjorde en påverkande faktor. Slutsats: Resultatet visar att hindrande faktorer för viljan skulle kunna påverkas positivt genom förbättrad HLR-utbildning. Klinisk betydelse: Med hjälp av identifierade faktorer kan befintlig HLR-utbildning ses över och eventuellt förbättras. Detta skulle kunna öka antalet ingripanden och därigenom överlevnaden vid hjärtstopp utanför sjukhus. / Background: The lethality is high in out-of-hospital cardiac arrests and only a few percent of the victim’s lives are saved. Early treatment is crucial for survival. People at the scene can increase the survival significantly through CPR interventions. To care and the act of caring is not exclusively for nurses. In cases of out-of-hospital cardiac arrest, the bystander could be the one that performs the act of caring. In many cases, however, no interventions are made although the arrest is witnessed and therefore no act of caring is being performed. Objective: The aim of this essay was to identify factors that influence people's willingness to intervene in out-of-hospital cardiac arrest. Method: This study was designed as a literature study and both quantitative and qualitative research articles were included in the analysis. Results: The result was based on potential bystander's assumptions of how they would act and actual bystanders experience having acted. Differences in factors affecting the willingness were observed between them. The will seemed influenced by fears, lack of CPR skills and the scenario surrounding the arrest. A family tie between the victim and the bystander appeared also as an influencing factor. Conclusion: The findings show that the non-willingness to act could be affected positively by improved CPR training. Clinical significance: In light to the identified factors, improvement of the existing CPR training and increased education could improve the probability of intervention by bystanders and out-of-hospital cardiac arrest survival.

This thesis investigated whether out­come after in-hospital cardiac arrest patients could be improved by a cardiopulmonary resuscitation (CPR) educational intervention focusing on all hospital healthcare professionals. Annually in Sweden, approximately 3000 in-hospital patients suffer a cardiac arrest in which CPR is attempted, and which 900 will survive. The thesis is based on five papers: Paper I was a methodological study concluding in a reliable multiple choice questionnaire (MCQ) aimed at measuring CPR knowledge. Paper II was an intervention study. The intervention consisted of educating 3144 healthcare professionals in CPR. The MCQ from Paper I was answered by the healthcare professionals both before (82% response rate) and after (98% response rate) education. Theoretical knowledge improved in all the different groups of healthcare professionals after the intervention. Paper III was an observational laboratory study investigating the practical CPR skills of 74 healthcare professionals’. Willingness to use an automated external defibrillator (AED) improved generally after educa­tion, and there were no major differences in CPR skills between the different healthcare professions. Paper IV investigated, by use of a questionnaire, the attitudes to CPR of 2152 healthcare professionals (82% response rate). A majority of healthcare professionals reported a positive attitude to resuscitation. Paper V was a register study of patients suffering from cardiac arrest. The intervention tended not to reduce the delay to start of treatment or to increase overall survival. However, our results suggested indirect signs of an improved cerebral function among survivors. In conclusion, CPR education and the introduction of AEDs in-hospital – improved healthcare professionals knowledge, skills, and attitudes – did not improve patients’ survival to hospital discharge, but the functional status among survivors improved.

Malgré de très nombreuses études expérimentales et cliniques dans le domaine de l'arrêt circulatoire, seulement 2% à 12% des patients quittent l'hôpital avec une bonne récupération neurologique. Il est donc nécessaire de proposer de nouvelles thérapeutiques pour tenter d'augmenter la survie après un arrêt circulatoire. Pour atteindre ce but il semble indispensable d'améliorer la qualité du massage cardiaque durant la réanimation et de protéger le myocarde et le cerveau contre les phénomènes d'ischémie-reperfusion. Dans la première partie de ce travail, nous avons évalués dans une étude pré hospitalière l'utilisation d'un dispositif innovant de massage cardiaque interne par minithoracotomie et montré une amélioration de l'hémodynamique en comparaison avec le massage cardiaque standard. Dans la deuxième partie, nous avons testés les possibles effets protecteurs de l'EPO (érythropoïétine) dans deux types d'arrêt circulatoire. Dans un modèle d'arrêt cardiaque expérimental chez le rat nous avons démontré que lorsque l'EPO était injectée avant l'arrêt cardiaque, la réanimation initiale était améliorée et la survie des animaux augmentée ce qui pouvaient suggérer un effet cardio et/ou neuroprotecteur de l'EPO contre les effets délétères de l'ischémie reperfusion. Dans une étude clinique en chirurgie cardiaque sous circulation extra corporelle, nous n'avons pas pu démontré d'effet bénéfique de l'EPO ni sur l'ischémie myocardique, ni sur l'ischémie cérébrale ni sur les paramètres de l'inflammation. Sur la base de ces deux études, il est donc difficile de conclure sur le potentiel rôle bénéfique de l'EPO dans l'arrêt circulatoire. Néanmoins, sur la seule base des résultats expérimentaux, l'EPO pourrait faire partie de l'arsenal thérapeutique pour mieux protéger le myocarde et le cerveau contre les effets délétères de l'ischémie reperfusion après un arrêt cardiaque. / Despite extensive experimental and clinical research on cardiac arrest, only 2-12% of resuscitated patients are discharged from hospital in good neurological conditions. There is, therefore, a dear need for new therapies that improve survival after cardiac arrest. It ‘s necessary to improve the quality of cardiac massage and to protect against cardiac and cerebral ischemia occurring during cardiac arrest. In a first part, we evaluated the prehospital feasibility of performing a new method of minimally invasive direct cardiac massage (MID-CM®) and we suggested that better haemodynamic results can be obtained than with standard cardiopulmonary resuscitation. In a second part, we tested erythropoietin (EPO) against placebo in two model of cardiac arrest. In an experimental model of cardiac arrest, we demonstrated that EPO, when administrated before cardiac arrest, improved initial resuscitation and increased the duration of post-resuscitation survival. In a second model of circulatory arrest during cardiac surgery with cardiopulmonary bypass, EPO administration did not protect against cerebral ischemia and inflammatory response occurring during cardiac surgery with CPB. It is difficult to make definitive conclusion on the potential role of EPO in myocardial and cerebral protection after circulatory arrest. We can hope that EPO administration will represent pharmacological approach in upcoming years to additional myocardial salvage of the reperfused myocardium after cardiac arrest.

Introdução: Parada Cardiorrespiratória (PCR) é uma emergência médica, quando ocorrer fora do ambiente hospitalar, o imediato atendimento à vítima é vital. A imediata Reanimação Cardiopulmonar (RCP), no ambiente extra-hospitalar é muito importante. A denominação aeroespacial reúne ambiente aéreo (cabine de aeronaves pressurizadas, altitude) e, espacial (ambiente com microgravidade, flutuação). No ambiente aéreo, importa a condição hipobárica e a hipóxia resultante. Quanto ao ambiente espacial, importa a condição de microgravidade e a incapacidade de exercer força e peso, como na superfície terrestre. Estes, e outros aspectos da RCP aeroespacial, são abordados no presente estudo. Objetivos: Ambiente aéreo: avaliar a qualidade do ar expirado, por um socorrista, durante RCP, em ambiente hipobárico, e, avaliar a suplementação de oxigênio para o socorrista, como forma de correção da mistura gasosa expirada, na altitude. Ambiente espacial: avaliar a eficácia de uma nova posição para RCP, por um só indivíduo, sem auxílio, na microgravidade. Materiais e Métodos: Utilizou-se uma câmara hipobárica, para a simulação da altitude, no ambiente aéreo. A RCP foi avaliada ao nível do mar e na altitude de 8.000 pés. Vôos parabólicos foram utilizados para a simulação de microgravidade. Um manequim foi o modelo de PCR em ambos os ambientes. No ambiente aéreo, avaliou-se a oferta de oxigênio expirada (boca-a-boca), pelo socorrista à vítima. Em microgravidade foi avaliada a efetividade da posição estudada, abraço da vítima com as pernas e o uso das mesmas, como apoio para a RCP, através da profundidade (mm), e freqüência (por minuto), das compressões torácicas e, da ventilação (volume de ar em mililitros). Resultados: Pressão de oxigênio cai de +108,3 mmHg (nível do mar), para +72,3 mmHg (8.000 pés). Com suplementação o valor é +108,0 mmHg. RCP em microgravidade: + 41,3 mm, + 80,2 /min, (sem ventilação). Massagem + ventilação (+ 44,0 mm, + 68,3 /min, + 491,0 ml de ar). Conclusões: Existe importante redução na oferta de oxigênio, à vítima de PCR, em altitude de 8.000 pés. Suplementação de oxigênio ao socorrista, 4 litros/minuto, por óculos nasal, pode corrigir esta redução. A posição proposta, para o ambiente espacial, deve ser considerada com uma possibilidade de RCP na microgravidade. / Introduction: Cardiac arrest (CA) is a medical emergency, and when occurring outside the hospital environment, immediate victim’s assistance is vital. Cardiopulmonary Resuscitation (CPR) at the extra-hospital environment is very important. Aerospace denomination joins an aerial environment (pressurized airplane cabins, altitude), and space (microgravity environment, floating). Within the aerial environment, hypobaric condition and resulting hypoxia do matter. Considering the space environment, microgravity condition and the inability to exert force and weight such as at the surface level, are important. Those and other aspects of aerospace CPR are approached in this present study. Objectives: Aerial environment: To evaluate the quality of exhaled air from the practitioner, during CPR within a hypobaric environment, and to assess supplemental oxygen offer to the practitioner as a form of correcting the exhaled gas mixture at altitude. Space environment: To assess the efficacy of a new CPR position, for a sole, unassisted individual at microgravity. Material and Methods: A hypobaric chamber for aerial environment altitude simulation was employed. CPR was assessed at sea level and at the altitude of 8,000 feet. Parabolic flights were employed for microgravity simulation. A CPR manikin was the model for both environments. At the aerial environment, exhaled (mouth-to-mouth) oxygen offer by the practitioner to the victim was assessed. In microgravity, the effectiveness of the studied position, which consisted of securing the victim with the legs and using them for CPR restraint, was evaluated by depth (millimeters), and frequency (per minute) of chest compressions, and ventilation (air volume in milliliters). Results: Oxygen pressure falls from ± 108.3 mmHg (at sea level) to ± 72.3 mmHg (8,000 feet). With supplementation, the value is ± 108.0 mmHg. CPR in microgravity: ± 41.3 mm, ± 80.2/minute (without ventilation). Massage + ventilation (± 44.0 mm, ± 68.3/minute, ± 491.0 ml of air). Conclusions: There is an important reduction of oxygen offer to the CPR victim at the altitude of 8,000 feet. Oxygen supplementation to the medic assistant at 4 liters/minute through nasal cannulae may correct such reduction. The proposed position for the spatial environment should be considered as a possibility for CPR at microgravity.