心肺复苏期间犬潮气末二氧化碳分压与冠状动脉灌注压的研究

Studies on the partial pressure of end-tidal carbon dioxide and the coronary perfusion pressure duringthe cardiopulmonary resuscitation in dogs

目的以电击致犬心室颤动建立的心搏骤停动物模型为研究对象,研究在心肺复苏(CPR)模式下犬潮气末二氧化碳分压(PETCO2)和冠状动脉灌注压(CPP)的变化及相关性。方法选健康杂种犬36只随机分为三组:4 min胸外复苏组、4 min开胸复苏组、8 min开胸复苏组。每组12只犬,雌、雄各半,致颤前及复苏过程中对PETCO2及CPP进行监测。根据自主循环恢复(ROSC)情况,比较复苏成功和复苏失败犬的CPP和PETCO2。结果 4 min胸外心肺复苏(CCCPR)时CPP与PETCO2的Pearson相关系数为0.992,P<0.05,CPP与PETCO2呈线性正相关。4 min开胸心肺复苏(OCCPR)时CPP与PETCO2的Pearson相关系数为0.937,P<0.05,CPP与PETCO2呈线性正相关。8 min OCCPR时CPP与PETCO2的Pearson相关系数为0.952,P<0.05,CPP与PETCO2呈线性正相关。4 min胸外复苏组ROSC 8只(66.7%),4 min开胸复苏组ROSC 12只(100%),8 min开胸复苏组ROSC 7只(58.3%)。在按压复苏1、2、5、10、15、20 min时,自主循环恢复组与失败组的CPP和PETCO2分别比较,两组之间差异均有统计学意义(P<0.05)。结论心肺复苏期间CPP与PETCO2关系密切,呈线性正相关,因此可以用PETCO2参数评价心肺复苏的预后效果。

Objective To study the changes in and correlations between the partial pressure of endtidal carbon dioxide （PETCO2） and the coronary perfusion pressure during cardio-pulmonary resuscitation （CPR） based on the cardiac arrest dog models of ventricular fibrillation by electric shock. Methods 36 healthy dogs were evenly randomized into 3 groups including 4 minutes close-chest CPR（CCCPR） group, 4 minutes open-chest CPR（OCCPR） group, and 8 minutes OCCPR group. There were 12 dogs in each group, half male and half female. In the process of CPR, all parameters about PETCO2 and CPP were recorded. Results In the 4 minutes CCCPR group, the correlation coefficient between the CPP and the PETCO2 was 0.992 （P〈0.05）, which was in positive linear correlation. In the 4 minutes OCCPR group, the correlation coefficient between the CPP and the PETCO2 was 0.937 （P 〈 0.05）, which also showed positive linear correlation. In the 8 minutes OCCPR group, the correlation coefficient between the CPP and the PETCO2 was 0.952 （P〈0.05）, and was also in positive linear correlation. The percentage of ROSC was 66.7（8/12） in the 4 minutes CCOPR group, 100%（12/12） in the 4 minutes OCCPR group and 58.3%（7/12） in the 8＆amp;nbsp;minutes OCCPR group. There were statistical differences in CPP, PETCO2 between models with ROSC and without ROSC at 1, 2, 5, 10, 15 and 20 mins of CPR （all P〈0.05）. Conclusions This research shows that there is a close positive linear relationship between the coronary perfusion pressure and the PETCO2, and PETCO2 could be used to evaluate the prognosis of the CPR.