Hwang S O, Lee K H, Cho J H, Oh B J, Gupta D S, Ornato J P, Lee S H, Yoon J, Choe K H
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, 162 IIsandong Wonju, South Korea.
Resuscitation. 2001 Mar;48(3):293-9. doi: 10.1016/s0300-9572(00)00250-1.
No existing device for cardiopulmonary resuscitation (CPR) is designed to exploit both the "cardiac pump" and the "thoracic pump" effect simultaneously. The purpose of this study was to measure the haemodynamic effect of a new simultaneous sternothoracic cardiopulmonary resuscitation (SST-CPR) device that could compress the sternum and constrict the thoracic cavity simultaneously in a canine cardiac arrest model. After 4 min of ventricular fibrillation, 24 mongrel dogs were randomized to receive standard CPR (n=12) or SST-CPR (n=12). SST-CPR generated a new pattern of the aortic pressure curve presumed to be the result of both sternal compression and thoracic constriction. SST-CPR resulted in significantly higher mean arterial pressure than standard CPR (68.9+/-16.1 vs. 30.5+/-10.0 mmHg, P<0.01). SST-CPR generated higher coronary perfusion pressure than standard CPR (47.0+/-11.4 vs. 17.3+/-8.9 mmHg, P<0.01). End tidal CO(2) tension was also higher during SST-CPR than standard CPR (11.6+/-6.1 vs. 2.17+/-3.3 mmHg, P<0.01). In this preliminary animal model study, simultaneous sternothoracic cardiopulmonary resuscitation generated better haemodynamic effects than standard, closed chest cardiopulmonary resuscitation.
现有的心肺复苏(CPR)设备均未设计为能同时利用“心泵”和“胸泵”效应。本研究的目的是在犬类心脏骤停模型中,测量一种新型的同时进行胸骨胸廓心肺复苏(SST-CPR)设备的血流动力学效应,该设备可同时按压胸骨并收缩胸腔。在室颤4分钟后,将24只杂种犬随机分为接受标准CPR组(n = 12)或SST-CPR组(n = 12)。SST-CPR产生了一种新的主动脉压力曲线模式,推测是胸骨按压和胸廓收缩共同作用的结果。SST-CPR导致的平均动脉压显著高于标准CPR(68.9±16.1 vs. 30.5±10.0 mmHg,P<0.01)。SST-CPR产生的冠状动脉灌注压高于标准CPR(47.0±11.4 vs. 17.3±8.9 mmHg,P<0.01)。SST-CPR期间的呼气末二氧化碳分压也高于标准CPR(11.6±6.1 vs. 2.17±3.3 mmHg,P<0.01)。在这项初步的动物模型研究中,同时进行胸骨胸廓心肺复苏比标准的闭胸心肺复苏产生了更好的血流动力学效应。