长时程室颤先行心肺复苏对复苏效果的影响及机制研究

The outcome and mechanism of CPR priority in a porcine model of prolonged ventricular fibrillation

目的比较7 min室颤先行心肺复苏2 min后除颤与直接除颤的复苏效果,并探讨其机制。方法建立猪闭胸电诱发室颤模型,CPR First组优先心肺复苏2 min后连续三次除颤,Shock First组直接予连续三次除颤,观察冠脉灌注压、室颤波频率和振幅变化,计算除颤成功率和自主循环恢复率。结果CPR First组先行心肺复苏2 min后可提高初次除颤前的冠脉灌注压、室颤波的频率和振幅,CPR First组比Shock First组有高的除颤成功率和自主循环恢复率(P<0.05)。结论7 min室颤除颤前先行胸外按压和人工呼吸可明显提高复苏成功率,其机制与增加冠脉灌注,改善心脏能量储备,提高室颤波的频率和振幅有关。

Objective To compare the efficacy and mechanism of CPR first or shock first on the outcome of 7 - minute ventricular fibrillation. Methods The ventricular fibrillation was electrically induced in a porcine model. After two minutes of CPR was performed, first preceding of non - stop three times defibrillation in CPR First groups While defibrillation was deliveried up to three times shocks in Shock First groups. If VF was no reversed after three times shocks, CPR was started for l minute. The rate of compression vs ventilation was 30： 2. The change of Coronary perfusion pressure, the VF＇ s frequency and amplitude were measured. The rate of successful defibrillation and return of spontaneous circulation were recorded. Results Precounter shock cardiopuhnonary resuscitation improved response to defibrillation from 7 minutes prolonged VF. Conclusion CPR priority improved the outcome of the prolonged ventricular fibrillation, the mechanism of which related improving coronary perfusion and increasing VF＇ s frequency and amplitude.