心肺复苏时静注不同剂量肾上腺素对主动脉内压力的影响

The effect of epinephrine on aortic pressure during cardiopulmonary resuscitation

目的：观察心肺复苏时静注不同剂量肾上腺素对主动脉压的影响。方法：对５例心脏骤停患者行心肺复苏的同时，经股动脉插管测压，观察静注不同剂量肾上腺素时主动脉内压力的变化。结果：在应用１ｍｇ肾上腺素时，主动脉内压力为（６．７７３±２．６６５）ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ），与用药前的压力（６．６１３±２．２６５）ｋＰａ比较，无显著性差异；当肾上腺素剂量增至每次５ｍｇ时，主动脉内压力增至（７．９７３±３．０４４）ｋＰａ，与应用１ｍｇ肾上腺素时比较，有显著性差异；而将肾上腺素剂量再增至每次１０ｍｇ时，主动脉内压力为（８．４５３±３．１４８）ｋＰａ，与肾上腺素剂量每次５ｍｇ时比较，无显著性差异。肾上腺素增加主动脉内压力效应的持续时间为（７．４５±１．４１）分钟，与剂量无关。结论：心肺复苏时，肾上腺素首剂可试用５ｍｇ，若需再次应用，可隔５分钟按原剂量追加，能获得较好的血管效应而避免过大剂量的不良影响。

Objective:To observe the effect of intravenous injection of epinephrine on aortic pressure response during cardiopulmonary resuscitation.Methods:During cardiopulmonary resuscitation,changes in aortic pressure response to various doses of epinephrine were measured via femoral artery in 5 patients.Results:It showed that aortic pressure responses were (6773±2665) kPa(1 kPa=75 mmHg) and (6613±2265) kPa in patients with and without 1 mg epinephrine injection,respectively,and the difference was not significant (P>005).After treatment with 5,10 mg epinephrine,aortic pressure increased to (7973±3044) kPa and (8453±3148) kPa,respectively.There was a significant difference between 1 mg and 5 mg epinephrine injection and without epinephrine injection,but no marked difference was found between 5 mg and 10 mg epinephrine treatment (P>005).In addition,duration of aortic pressure response was (745±141) minutes regardless of the doses of epinephrine.Conclusions:Our data suggest that 5 mg of epinephrine can be used for the first time during cardiopulmonary resuscitation,and the same dose would be repeated every 5 minutes whenever it needed.