气动胸腹反向按压心肺复苏装置应用的动物实验研究

The experimental study on the device of pneumatic cardiopulmonary resuscitation with chestabdomen reverse compression

目的 :对比观察应用气动胸腹反向按压心肺复苏装置与常规胸外心脏按压的复苏效果 ,并进一步探讨胸腹反向按压心肺复苏技术对脏器保护的可能机制。方法 :用静注高钾冷停跳液法造成猪心脏停搏模型 ,在复苏过程中分别观测气动胸腹反向按压心肺复苏装置和传统胸外按压心肺复苏法 2组动物冠状动脉灌注压、血气分析、血乳酸、氧自由基、细胞因子检测及组织病理观察。结果 :与传统胸外按压心肺复苏法相比 ,气动胸腹反向加压心肺复苏装置可使冠状动脉灌注压平均增加 3 5.8% ,动静脉血氧分压差增加 ,血乳酸水平降低 ,脑组织匀浆中超氧化物歧化酶 ( SOD)活性升高、丙二醛 ( MDA)水平下降 ,肿瘤坏死因子 α( TNFα)及白介素 1( IL 1 )的水平明显降低 ,心、肺、脑等重要脏器损伤减轻。结论 :气动胸腹反向按压心肺复苏装置通过提供更稳定、有效的心脏血流灌注 ,提高组织供氧及氧利用 ,减轻由于缺血缺氧造成的组织细胞膜氧化损伤及组织间缺血性炎症反应 ,从而综合地起到更为有效的重要脏器 (心、肺、脑 )保护作用 ,复苏效果明显优于传统的单纯胸外按压。

Objective:To observe the effect of the device of pneumatic cardiopulmonary resuscitation with chestabdomen reverse compression and its potential mechanism underlying organ protection.Methods:Cold high kalium fluid was intravenously infused to reproduce the pig model of cardiac arrest.Compared with traditional cardiopulmonary resuscitation,the changes in coronary artery perfusion pressure,artery blood gas and lactic acid in the two groups within 30 minutes after cardiac arrest were observed .In addition,levels of brain oxygen free radicals and cytokines as well as pathological examination were also determined.Results:Compared with the control group,chestabdomen reverse compression could not only increase coronary artery perfusion pressure by 35 8%,increase the difference of arteriovenous oxygen,reduce serum lactic acid level,but also increase the activity of superoxide dismutase(SOD) and decrease the levels of malondialdehyde(MDA),tumor necrosis factorα(TNFα) and interleukin1(IL1) in brain.Meanwhile,the damage of heart,lungs,and brain was alleviated.Conclusions:The device can provide more stable and effective cardiac perfusion,improve the tissue oxygen delivery and oxygen consumption,inhibit the oxidation injury of cell membrane and ischemic inflammatory response.This procedure might have protective effect on vital organ (heart,lungs,and brain) in the resuscitation of cardiac arrest.