不同频率插入式腹部按压心肺复苏对室颤犬血流动力学的影响

Effeets of interposed abdominal compression-CPR at different frequency on hemodynamics

目的对不同频率插入式腹部按压心肺复苏及标准心肺复苏产生的血流动力学参数进行比较,探讨IAC-CPR的最佳按压频率。方法选12条健康杂种犬,每条实验犬均接受S-CPR和80IAC-CPR、100IAC-CPR、120IAC-CPR四种复苏方法,每只犬四种复苏方法的顺序由随机法确定,每种按压方法进行5min。体外电击法制作犬室颤模型,采用6F猪尾导管及压力换能器,测量中心静脉压(CVP)、升主动脉收缩和舒张压、颈动脉收缩(CAS)和舒张压(CAD),并通过公式计算获得冠状动脉灌注压(CPP)、平均主动脉压(MAP)及平均颈动脉压(CMAP)。结果100IAC-CPR产生的MAP、CMAP、CVP均大于其他三种按压方法(P<0·05),产生的CPP和120IAC-CPR相当(P>0·05),优于其余两种按压方法(P<0·05)。结论100IAC-CPR能产生最好的血流动力学效果,主要表现为能产生更好的CPP和CMAP,预示可能产生更好的复苏成功率,而且易于操作和维持。

Objective To study the differences of hemodynamics between interposed abdominal compression （IAC） -CPR with different frequency and standard-CPR. Methods Twelve healthy and mongrel canines were randomly resuscitated for 5 minutes by four methods including S-CPR, 80IAC-CPR, 100IAC-CPR, 120IAC-CPR. The model of ventricular fibrillation was induced by electric shock in vitro. Using 6F pigtail catheter and pressure transducer, the center vein pressure （CVP）, the diastolic and systolic pressure in the ascending aorta, the diastolic and systolic press-ure in the carotid were measured, and the coronary perfusion pressure （CPP）, the mean aorta pressure （MAP）, the mean carotid artery pressure （MCAP） were calculated by formula. Results The MAP, MCAP, and CVP in 100IAC-CPR group were higher than those in the other three groups （ P〈0.05） . The CPP in 1001AC-CPR was similar to that in 1201AC-CPR group （ P 〉 0.05）, but ,was higher than that in the other two groups （ P〈0.05）. Conclusion 100IAC-CPR produced the best hemodynamic effect, especially the best CPP and CMAP. 100IAC-CPR method had higher successful rate of resuscitation, and was easier to control and to keep.