Adams Jose A, Wu Dongmei, Bassuk Jorge, Kurlansky Paul
Department of Research, Divisions of Neonatology, Mount Sinai Medical Center, Miami Heart Research Institute, Miami Beach, FL 33140, USA.
Resuscitation. 2004 Mar;60(3):327-34. doi: 10.1016/j.resuscitation.2003.10.009.
Cardiopulmonary resuscitation (CPR) can be achieved by repetitive motion of the body headwards to footwards in the spinal axis, at 2 Hz and +/- 0.6 G in a juvenile pig model of ventricular fibrillation. Return of spontaneous circulation and normal neurological outcome occurred after a total of 22 min of ventricular fibrillation that included a 3-min noninterventional period [Resuscitation 56 (2003) 215; Resuscitation 51 (2001) 55]. Since older pigs have stiffer rib cages than juvenile pigs and their hemodynamic response to various stimuli might differ, this study was carried out to determine whether this method of CPR, termed pGz-CPR, was just as effective in older pigs. pGz-CPR was also compared to chest compression CPR using an automated mechanical device (CONV-CPR). Ventricular fibrillation was instituted in older pigs weighing 23-34 kg and a 3-min noninterventional period was observed, followed by 15 min pGz-CPR in eight pigs or 15 min CONV-CPR in eight pigs. Return of spontaneous circulation (ROSC) occurred after defibrillation in all eight pigs with pGz-CPR and in six of eight pigs with CONV-CPR. Two of eight pigs with CONV-CPR and none of the eight pigs with pGz-CPR had rib fractures. Hemodynamic instability 15 min after ROSC occurred in all animals with CONV-CPR whereas only three of eight pigs with pGz-CPR demonstrated hemodynamic instability (P < 0.05). We conclude that pGz-CPR in older pigs produces similar ROSC reported by other investigators in pigs without the risk of rib fractures. Further, pGz-CPR is associated with a lower incidence of periods of hemodynamic instability following ROSC than CONV-CPR.
在幼年猪心室颤动模型中,通过沿脊柱轴线从头到脚的身体重复运动,以2赫兹的频率和±0.6G的加速度可实现心肺复苏(CPR)。在总共22分钟的心室颤动(其中包括3分钟的非干预期)后,实现了自主循环恢复和正常神经功能结局[《复苏》56(2003年)215页;《复苏》51(2001年)55页]。由于成年猪的肋骨胸廓比幼年猪更僵硬,且它们对各种刺激的血流动力学反应可能不同,因此开展本研究以确定这种称为pGz-CPR的心肺复苏方法在成年猪中是否同样有效。还将pGz-CPR与使用自动机械装置进行的胸外按压心肺复苏(CONV-CPR)进行了比较。对体重23 - 34千克的成年猪诱发心室颤动,并观察3分钟的非干预期,随后8只猪接受15分钟的pGz-CPR,另外8只猪接受15分钟的CONV-CPR。接受pGz-CPR的所有8只猪和接受CONV-CPR的8只猪中的6只在除颤后实现了自主循环恢复(ROSC)。接受CONV-CPR的8只猪中有2只发生肋骨骨折,而接受pGz-CPR的8只猪均未发生肋骨骨折。所有接受CONV-CPR的动物在ROSC后15分钟出现血流动力学不稳定,而接受pGz-CPR的8只猪中只有3只表现出血流动力学不稳定(P < 0.05)。我们得出结论,成年猪中的pGz-CPR产生了其他研究者在猪中报道的类似自主循环恢复情况,且没有肋骨骨折的风险。此外,与CONV-CPR相比,pGz-CPR在ROSC后血流动力学不稳定期的发生率更低。