呼吸停止病人声门前高浓度输氧对心律与心电活动的影响

Effect of high flow oxygen therapy in the glottal prozone upon on cardiac rhythm and electrocardiac activity in brain death patients

目的以鼻导管经声门输注高浓度氧气,观察自主呼吸停止的脑死亡病人自主心搏维持时间及心电活动的演变,探讨其在CPR中的价值。方法把50例脑死亡病人随机分为不输氧的对照组和声门前输氧(10 L/min)的实验组,在停止呼吸机支持后分别观察其心律及心电演变,并把所有数据做统计学分析。结果对照组和实验组对比,自主心搏维持时间差异有显著性(P<0.05),自主心搏与年龄呈负相关,自主心搏维持时间与脑死亡时间无关(P>0.05)。结论对呼吸停止的病人在声门前高浓度输氧可以有效延长心搏维持时间,标准规范的胸外按压配合鼻导管声门前高浓度供氧(10 L/min)至少在7 min内不必进行口对口人工呼吸。

Objective To investigate the holding time of autonomous cardiac rhythm and the development of electrocardiac activity in brain death patients accepted high flow oxygen therapy since respiration ceased. Methods 50 cases brain death patient were randomly devided into experimental group with oxygen given in the glottal prozone and control group without oxygen given. The cardiac rhythm and the development of the electrocardiac activity was observed after the mechanical ventilation was stopped. Statistic analysis was made on the data. Results There were significant differences in the holding time of autonomous cardiac rhythm between experimental group and control group（ P 〈 0. 05 ）. Age was negative correlated to autonomous heartbeat. The holding time of autonomous heartbeat was unrelated to the time after brain death（ P〉0. 05）. Conclusion High flow oxygen given in glottal prozone can prolong the holding time of the autonomous heartbeat in patients with respiratory arrest. Proper cardiac compression coordinated with nasal catheter oxygen inhalation in 10 L/min in glottal prozone can support for 7 mintutes.