胸外按压同步通气模式在猪心肺复苏模型中对脑组织氧合的作用

Effect of chest compression synchronized ventilation on cerebral hypoxia in a porcine cardiopulmonary resuscitation model

目的探讨胸外按压同步通气模式在猪心肺复苏模型中对脑组织的氧合改善作用。方法构建猪室颤模型,信封法随机分组,根据心肺复苏时呼吸机通气模式不同,分别命名为IPPV组、CCSV组,记录复苏时4 min、7 min,自主循环恢复后30 min三个时间点动脉血乳酸值;复苏过程中1~8 min内颈动脉血流流速;复苏后1 h、2 h、3 h、4 h脑氧饱和度;评估复苏后24 h神经系统评分。结果两组对比,3个时间点血气分析显示:CCSV组猪乳酸值明显低于IPPV组;复苏过程中1~8 min CCSV组颈动脉的血流流速明显高于IPPV组;复苏后各个时间点脑氧饱和度亦明显高于IPPV组;复苏后24 h CCSV组神经系统评分明显降低。结论猪室颤模型在心脏骤停复苏过程选择CCSV通气模式中可明显改善复苏时及复苏后的脑组织缺氧情况。

Objective To investigate the effect of chest compression synchronized ventilation on cerebral hypoxia in porcine cardiopulmonary resuscitation model.Methods The porcine ventricular fibrillation model was constructed and randomly(random number)divided into two groups by envelope method.According to the different modes of ventilator during cardiopulmonary resuscitation,they were named intermittent positive pressure ventilation(IPPV)group and chest compression synchronized ventilation(CCSV)group.The arterial blood lactic acid value at 4 and 7 min after resuscitation and 30 min after spontaneous circulation recovery,carotid blood flow(CBF)within 1-8 min during resuscitation,cerebral oxygen saturation at 1,2,3,and 4 h after resuscitation were recorded.Neurological score was assessed 24 h after resuscitation.Results The lactic acid value at 3 time points in the CCSV group was significantly lower than that in the IPPV group;during the resuscitation,the CBF of the pig carotid artery in the CCSV group was significantly higher than that in the IPPV group within 1-8 min during resuscitation;cerebral oxygen saturation was also significantly higher in the IPPV group at all time points after resuscitation.The neurological score of the CCSV group decreased significantly 24 h after resuscitation.Conclusions The choice of CCSV ventilation mode in porcine ventricular fibrillation model can significantly improve the cerebral hypoxia during cardiac arrest and resuscitation。