摘要
本资料显示急性及慢性病呼吸心搏骤停初期均存在酸血症,其程度取决基础疾病。复苏中使用碳酸氢钠(SBC)纠酸较适宜,有效通气及首次补给标准量SBC后,急病组pH、PaCO_2,AB、BE有显著性改善,慢病组除pH、PaCO_2有改善外,AB、BE改善不显著(P>0.05),表明首次标准量SBC对急病骤停者合理,慢病骤停者量偏小,pH7.20~7.25的初期复苏有效者急病组82%,慢病组80%,均高于问组pH<7.20或>7.25者。作者主张将pH值控制在7.20~7.25为宜。急病骤停者超过6min未恢复自主呼吸循环,宜及时补以标准量SBC,随后根据动脉血气分析追加,慢病骤停者应结合原发病分析,骤停前有酸血症倾向者,应及早给予标准量SBC或适宜加大量,无必要快速完全予以纠正。
This study showed that acidemia was seen in theearly period
of respiratory and particularly cardiacarrest due to both acute and chronic diseases (groupof
acute illness and group of chronic illness).The se-verity of acidemia depended on the
underlying dis-eases.Use of sodium bicarbonate(SBC) was indicatedin the
resuscitation.Marked.improvement(p<0.01)of various parameter (PH,PaCO_2,AB,BE)was seenin
the group of acute illness after the efficient ventila-tion and the first administration of a standard
doseof SBC.In the group of chronic illness,pH andPaCO_2 were significantly improved,but no
markedimprovement of AB and BE was found(P>0.05).Thos Showed that the first standard dose
of SBC wasappropriate for treating respiratory and cardiac ar-rest due to acute underlying
diseases but seemed tobe inadequate for treating the arrest due to chronicunderlying diseases.
The success rate of the primaryresuscitation was 82% in the group of acute illnessand 80%in
the group of chronic illness when the pa-tients,pH was7.20-7.25.This result reflected that
re-suscitation in patients with pH values being7.20-7.25 was mostly effective as compared with
theother patients in the same group with pH values lessthan 7.20 or more than 7.25.Hence it is
considered tobe appropriate to keep the pH values in the range of7.20-7.25.A standard dose of
SBC should be given tothe patients with respiratory and cardiac arrest(lasting more than six
minutes)due to acute underlyingdisease and a supplementary dose based on the arte-rial blood
gas analysis is administered.A timelystandard dose or a properly increased dose of SBCshould
be given to the patients with respiratory andcardiac arrest due to chronic underlying
diseaseswhich have a tendency toward academia according tothe clinical analysis,but a
dramatic and completecorrection of acidosis is unnecessary.
出处
《中国危重病急救医学》
CAS
CSCD
1994年第2期85-88,共4页
Chinese Critical Care Medicine
关键词
呼吸心搏骤停
酸碱平衡
碳酸氢钠
respiratory and cardiac
arrest
acid-basebalance:sodium bicarbonate