Langhelle Audun, Strømme Taevje, Sunde Kjetil, Wik Lars, Nicolaysen Gunnar, Steen Petter Andreas
Institute for Experimental Medical Research, Ulleval University Hospital, N-0407 Oslo, Norway.
Resuscitation. 2002 Jan;52(1):39-48. doi: 10.1016/s0300-9572(01)00442-7.
The use of an inspiratory impedance threshold valve (ITV) during cardiopulmonary resuscitation (CPR) should reduce intrathoracic pressure during natural chest recoil or active chest decompression. This might in turn improve venous return and thereby organ blood flow. The haemodynamic effects during both standard CPR and active compression-decompression (ACD)-CPR with and without the ITV, therefore, were studied in a well-established porcine model with cross-over design. Sixteen pigs were randomised to one of four methods initially, changing the method every fifth minute during mechanical chest compression at 100 min(-1). Myocardial blood flow was doubled when the valve was added to standard CPR, median (q25-q75) 14 (3-47) versus 27 (9-51) ml min(-1) 100 g(-1) (P=0.001). ACD-CPR caused a similar increase, while adding the ITV to ACD-CPR only tended to increase myocardial blood flow (P=0.077). Varying the technique had no effect on cerebral, kidney or carotid blood flow, coronary perfusion pressure, expired CO(2) concentrations or blood gases. The valve is a promising new tool in CPR, but more independent studies of the device are needed.
在心肺复苏（CPR）过程中使用吸气阻抗阈值阀（ITV），应能在自然胸壁回弹或主动胸壁减压时降低胸内压。这反过来可能会改善静脉回流，从而增加器官血流量。因此，在一个成熟的采用交叉设计的猪模型中，研究了在有和没有ITV的情况下，标准CPR以及主动按压-减压（ACD）-CPR期间的血流动力学效应。16头猪最初被随机分为四种方法之一，在以100次/分钟进行机械胸外按压期间，每五分钟更换一次方法。当在标准CPR中添加该阀时，心肌血流量增加了一倍，中位数（四分位数间距）为14（3-47）对27（9-51）ml·min⁻¹·100g⁻¹（P=0.001）。ACD-CPR也引起了类似的增加，而仅在ACD-CPR中添加ITV仅使心肌血流量有增加趋势（P=0.077）。改变技术对脑、肾或颈动脉血流量、冠状动脉灌注压、呼出二氧化碳浓度或血气没有影响。该阀是CPR中一种有前景的新工具，但还需要对该设备进行更多独立研究。
