Oxylator和阻抗阈值瓣膜对猪心肺复苏时冠脉灌注压的影响

Effect of Oxylator and impedance threshold valve on coronary perfusion pressure during cardiopulmonary resuscitation in pigs

目的:研究Oxylator,阻抗阈值瓣膜(ITV)以及Oxylator和ITV同时应用对血流动力学和冠脉灌注压(CPP)的影响。方法:将12头猪采用超速抑制刺激诱发室颤2 min后,立即予以3 min的心肺复苏(CPR)。在每头猪CPR时,监测随机应用手捏皮球、Oxylator、ITV以及Oxylator和ITV时的血流动力学变化和CPP。结果:①CPR时,手捏皮球、Oxylator、ITV、ITV+Oxylator的CPP分别为(21.6±1.98)、(25.2±2.08)、(30.7±2.56)和(22.7±2.06)mmHg,以ITV最高(P<0.05)。4种方法的左心室收缩压和主动脉收缩压无明显变化(P均>0.05);②累积除颤能量ITV组为(430±57.1)J,低于手捏皮球组(500±0)J、Oxylator组(860±0)J和ITV+Oxylator组(530±30.0)J(P<0.05)。结论:①4种方法的左室收缩压和主动脉收缩压无明显变化;②应用ITV的CPP最高,累积除颤能量最低,可能与该组的CPP高有关。

Objective： To investigate the hemodynamics and coronary perfusion pressure（CPP） impacted by Oxylator and the impedance threshold valve （ITV） during cardiopulmonary resuscitation （CPR）. Methods： ACD-CPR （active compression decompression CPR） was performed on twelve pigs in ventricular fibrillation （VF） models. After two minutes, each pig randomly received ITV, Manual, Oxyhor, or ITV combined with Oxylator during three minutes of ACD-CPR. Results： The CPP during CPR in Manual, Oxylator, ITV and ITV ＋ Oxyaltor was （21.6 ±1.98）mmHg, （25.2±2.08）mmHg,（30.7 ±2.56）mmHg and （22.7±2.06）mmHg, respectively. There were no differences of left peak ventricular pressure and aortic peak pressure during the compression phase of CPR in Manual, ITV, Oxylator and ITV ＋ Oxyaltor. The cumulative successful defibrillation energy in ITV, Manaul, Oxylator and ITV ＋ Oxyaltor was （430±57.1） J, （500±0） J, （860±0） J and （530±30.0） J, respectively. Conclusions： （1） ITV＋ Manual is the best for CPP among the four episodes. （2） There are no significant differences of left ventricular and aortic peak pressure during compression phase of CPR among the four episodes when ACD-CPR is used. The mean aortic pressure during CPR also is not significantly changed among the four episodes. （3） ITV ＋ Manual is the best to defibrillate of the four episodes, probably because its CPP is the largest in this episode.