中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2013年
10期
1112-1116
,共5页
刘同英%王鲁宁%周满红%单立婧%吴开莉
劉同英%王魯寧%週滿紅%單立婧%吳開莉
류동영%왕로저%주만홍%단립청%오개리
自发濒死呼吸%心室颤动%心脏骤停%心肺复苏%冠状动脉灌注压%主动脉压%右心房压
自髮瀕死呼吸%心室顫動%心髒驟停%心肺複囌%冠狀動脈灌註壓%主動脈壓%右心房壓
자발빈사호흡%심실전동%심장취정%심폐복소%관상동맥관주압%주동맥압%우심방압
Spontaneous agonal respiration%Ventricular fibrillation (VF)%Cardiac arrest%Cardiaopulmonary resuscitation%Coronary perfusion pressure%Aortic pressure%Right atrial pressure
目的 探讨心脏骤停(CA)(心室颤动)家猪模型中濒死呼吸对冠状动脉灌注压(CPP)的影响、意义及其可能的机制.方法 10头健康雄性家猪,体质量(25.0±1.5) kg.常规麻醉、气管插管.经右股动脉置管至胸主动脉实时监测主动脉压力(AOP).经右颈外静脉置管至右心房实时监测右心房压力(RAP).经心内膜交流电刺激诱发心室颤动(VF)致CA.未处理时间8 min.采集濒死呼吸前后AOP、RAP计算CPP并进行统计学分析,濒死呼吸前后CPP数值比较采用前后配对t检验.结果 所有动物心脏骤停(心室颤动)模型均一次制作成功并出现濒死呼吸.濒死呼吸吸气前1 sCPP为(7.18 ±4.22) mm Hg(1 mm Hg =0.133 kPa)；呼气后0 s为(11.78±5.16) mm Hg,明显高于濒死呼吸前水平(t=-3.140,P=0.012 ＜0.05)；呼气后5 s为(8.75±4.38)mm Hg,与吸气前1 s比较明显升高(t=-2.828 P=0.020 ＜0.05)；呼气后6 s为(8.23±4.55) mmHg,与吸气前1 s比较,差异无统计学意义,t=-1.778 P=0.109 ＞0.05.结论 濒死呼吸是心脏骤停的伴随表现,濒死呼吸后CPP升高并持续至呼气末5 s有利于心肺复苏.
目的 探討心髒驟停(CA)(心室顫動)傢豬模型中瀕死呼吸對冠狀動脈灌註壓(CPP)的影響、意義及其可能的機製.方法 10頭健康雄性傢豬,體質量(25.0±1.5) kg.常規痳醉、氣管插管.經右股動脈置管至胸主動脈實時鑑測主動脈壓力(AOP).經右頸外靜脈置管至右心房實時鑑測右心房壓力(RAP).經心內膜交流電刺激誘髮心室顫動(VF)緻CA.未處理時間8 min.採集瀕死呼吸前後AOP、RAP計算CPP併進行統計學分析,瀕死呼吸前後CPP數值比較採用前後配對t檢驗.結果 所有動物心髒驟停(心室顫動)模型均一次製作成功併齣現瀕死呼吸.瀕死呼吸吸氣前1 sCPP為(7.18 ±4.22) mm Hg(1 mm Hg =0.133 kPa)；呼氣後0 s為(11.78±5.16) mm Hg,明顯高于瀕死呼吸前水平(t=-3.140,P=0.012 ＜0.05)；呼氣後5 s為(8.75±4.38)mm Hg,與吸氣前1 s比較明顯升高(t=-2.828 P=0.020 ＜0.05)；呼氣後6 s為(8.23±4.55) mmHg,與吸氣前1 s比較,差異無統計學意義,t=-1.778 P=0.109 ＞0.05.結論 瀕死呼吸是心髒驟停的伴隨錶現,瀕死呼吸後CPP升高併持續至呼氣末5 s有利于心肺複囌.
목적 탐토심장취정(CA)(심실전동)가저모형중빈사호흡대관상동맥관주압(CPP)적영향、의의급기가능적궤제.방법 10두건강웅성가저,체질량(25.0±1.5) kg.상규마취、기관삽관.경우고동맥치관지흉주동맥실시감측주동맥압력(AOP).경우경외정맥치관지우심방실시감측우심방압력(RAP).경심내막교류전자격유발심실전동(VF)치CA.미처리시간8 min.채집빈사호흡전후AOP、RAP계산CPP병진행통계학분석,빈사호흡전후CPP수치비교채용전후배대t검험.결과 소유동물심장취정(심실전동)모형균일차제작성공병출현빈사호흡.빈사호흡흡기전1 sCPP위(7.18 ±4.22) mm Hg(1 mm Hg =0.133 kPa)；호기후0 s위(11.78±5.16) mm Hg,명현고우빈사호흡전수평(t=-3.140,P=0.012 ＜0.05)；호기후5 s위(8.75±4.38)mm Hg,여흡기전1 s비교명현승고(t=-2.828 P=0.020 ＜0.05)；호기후6 s위(8.23±4.55) mmHg,여흡기전1 s비교,차이무통계학의의,t=-1.778 P=0.109 ＞0.05.결론 빈사호흡시심장취정적반수표현,빈사호흡후CPP승고병지속지호기말5 s유리우심폐복소.
Objective To investigate the effects of spontaneous agonal respiration on coronary perfusion pressure (CPP) during untreated cardiac arrest (ventricular fibrillation) in swine model.Methods Ten male healthy domestic swines (25.0 ± 1.5) kg were anaesthetised,intubated and mechanically ventilated.The catheterizations were separately inserted into the right atrium and thoracic aorta to monitor aortic pressure (AOP) and right atrial pressure (RAP).A pacing electrode was inserted into the right ventricle to induce ventricular fibrillation (VF).VF was induced by intra-ventricular stimulation withalternating electric current and untreated for 8 minutes.AOP and RAP were recorded until respiratory activity ceased.The CPP before and after agonal respiration was calculated and analyzed by paired-sample T test.Results All animals presented with agonal respiration from 1 to 6 minutes after VF during the first attempt.The CPP was (7.18 ±4.22) mmHg at 1 sec before agonal respiration,(11.78 ±5.16) mmHg at 0 sec after agonal respiration,(8.75 t:4.38) mmHg at 5 sec after agonal respiration and (8.23 ± 4.55)mmHg at 6 sec after agonal respiration.The CPP at 0 sec after agonal respiration was higher than that before agonal respiration (t =-3.140,P =0.012).The CPP at 5 sec after agonal respiration was higher than that at 1 sec before agonal respiration (t =-2.828,P =0.020).There was no difference in CPP between at 6 sec after agonal respiration and at 1 sec before agonal respiration (t =-1.778,P =0.109).Conclusions Agonal respiration accompanies ventricular fibrillation.After agonal respiration,the coronary perfusion pressure is increased for 5 seconds being in favor of cardiaopulmonary resuscitation.
