CAJ | 학술논문

目的：通过分析大鼠心肺复苏期间叹气样呼吸（gasping）出现的时间及频率，评价其对心脏停搏（cardiac arrest，CA）时间及复苏后心功能不全程度的预测价值。方法27只健康SD大鼠，根据CA的时间不同随机分为3组：CA 4 min，CA 6 min和CA 8 min，每组9只。实验采用电刺激法诱导CA，在动物经历不同时间的CA后，各组均进行8 min的心肺复苏，记录复苏期间动物的gasping信息及复苏效果。在CA前、复苏后1 h、2 h及4 h进行超声心动图检查，评估心输出量、射血分数和心肌做功指数（Tei指数）等心功能指标的变化。结果在CA 4 min组，gasping的出现最早、频率最高，随着CA时间的延长，gasping的出现推迟、频率下降，且3组间比较差异具有统计学意义。在gasping频繁的CA 4 min组，所有动物在8 min的复苏期间成功复苏，且除颤次数最少，其复苏效果明显好于CA 8 min组，差异具有统计学意义。复苏后的心功能评估中，较好的心输出量、射血分数及Tei 指数出现在gasping频繁的CA 4 min组，CA 6 min组次之，CA 8 min组最差，3组间比较具有统计学差异。结论心肺复苏期间，gasping出现越早、频率越高，提示较短的CA时间，并预示较好的复苏成功率及复苏后心功能。
목적：통과분석대서심폐복소기간우기양호흡（gasping）출현적시간급빈솔，평개기대심장정박（cardiac arrest，CA）시간급복소후심공능불전정도적예측개치。방법27지건강SD대서，근거CA적시간불동수궤분위3조：CA 4 min，CA 6 min화CA 8 min，매조9지。실험채용전자격법유도CA，재동물경력불동시간적CA후，각조균진행8 min적심폐복소，기록복소기간동물적gasping신식급복소효과。재CA전、복소후1 h、2 h급4 h진행초성심동도검사，평고심수출량、사혈분수화심기주공지수（Tei지수）등심공능지표적변화。결과재CA 4 min조，gasping적출현최조、빈솔최고，수착CA시간적연장，gasping적출현추지、빈솔하강，차3조간비교차이구유통계학의의。재gasping빈번적CA 4 min조，소유동물재8 min적복소기간성공복소，차제전차수최소，기복소효과명현호우CA 8 min조，차이구유통계학의의。복소후적심공능평고중，교호적심수출량、사혈분수급Tei 지수출현재gasping빈번적CA 4 min조，CA 6 min조차지，CA 8 min조최차，3조간비교구유통계학차이。결론심폐복소기간，gasping출현월조、빈솔월고，제시교단적CA시간，병예시교호적복소성공솔급복소후심공능。
Objective To analyze the timing and frequency of spontaneous gasping during cardiopulmonary resuscitation in a rat model,and evaluate its value bearing some relation to duration of cardiac arrest (CA ) in predicting the severity of post-resuscitation myocardial dysfunction.Methods Twenty-seven healthy Sprague-Dawley rats were randomly (random number)divided into 3 groups according to different durations of CA:CA 4 min (n=9),CA 6 min (n=9)and CA 8 min (n=9).CA of rats was electrically induced and untreated for 4,6 or 8 min respectively in the corresponding groups,and then cardiopulmonary resuscitation (CPR)was initiated and continued for 8 min in all animals.The emergence timing and frequency of spontaneous gasping during cardiopulmonary resuscitation and resuscitation outcomes were documented.Myocardial function such as cardiac output,ejection fraction and Tei index was measured by echocardiography prior to CA and at 1 h,2 h and 4 h post-resuscitation.Results The earliest appearance of gasping with highest frequency was observed in the CA 4 min group during CPR.Gasping appeared later with decreased frequency observed following longer duration of CA.There were statistically significant differences in the timing and frequency of gasping among the 3 groups.In the CA 4 min group with frequent gasping,all animals were successfully resuscitated with 8-min CPR with the least number of defibrillation,which was significantly better than that in the CA 8 min group.During the evaluation of post-resuscitation myocardial function,cardiac output,ejection fraction and myocardial work index (Tei index) were better in the CA 4 min group with frequent gasping,worse in the CA 6 min group and worst in the CA 8 min group, showing statistically significant differences in cardiac function among the 3 groups. Conclusions The spontaneous gasping appeared sooner with higher frequency during cardiopulmonary resuscitation indicated shorter duration of CA,and predicted better success of resuscitation and post-resuscitation myocardial function.