Federiuk C S, Sanders A B, Kern K B, Nelson J, Ewy G A
Department of Surgery, University of Arizona Health Sciences Center, Tucson.
Ann Emerg Med. 1991 Nov;20(11):1173-7. doi: 10.1016/s0196-0644(05)81465-9.
This study attempted to determine the effect of bicarbonate administration on resuscitation in a porcine model of prolonged cardiac arrest.
After instrumentation, 26 swine were subjected to ventricular fibrillation for 15 minutes (16 animals) or 20 minutes (ten animals) with no resuscitative efforts.
Resuscitation attempts with open-chest cardiac massage and epinephrine were used in all animals after the arrest period. The experimental group was given sodium bicarbonate (3 mEq/kg), and the control group received 3% saline (5 mL/kg) at the initiation of cardiac massage.
Resuscitation success, hemodynamics, and arterial and mixed venous gases were compared in the bicarbonate and hypertonic saline-treated groups.
There was no difference in resuscitation rates between bicarbonate and nonbicarbonate-treated swine. After 15 minutes of ventricular fibrillation, six of eight bicarbonate-treated swine were resuscitated successfully compared with five of eight hypertonic saline-treated animals. None of the five bicarbonate-treated or five hypertonic saline-treated swine that underwent 20 minutes of ventricular fibrillation were resuscitated. The arterial and mixed venous pH values were significantly different in the bicarbonate-treated animals from values in the control group. There was no difference in systolic or diastolic blood pressures or myocardial perfusion pressure between the bicarbonate and hypertonic saline-treated animals.
Despite correlation of arterial and venous acidemia, the use of sodium bicarbonate did not improve resuscitation from prolonged cardiac arrest.
本研究试图在猪长时间心脏骤停模型中确定给予碳酸氢盐对复苏的影响。
在安装仪器后，26头猪经历15分钟（16只动物）或20分钟（10只动物）的室颤，期间不进行复苏努力。
在骤停期后，所有动物均采用开胸心脏按压和肾上腺素进行复苏尝试。实验组在心脏按压开始时给予碳酸氢钠（3 mEq/kg），对照组给予3%盐水（5 mL/kg）。
比较碳酸氢盐组和高渗盐水治疗组的复苏成功率、血流动力学以及动脉血和混合静脉血气体指标。
碳酸氢盐治疗组和未用碳酸氢盐治疗的猪之间的复苏率无差异。室颤15分钟后，8只接受碳酸氢盐治疗的猪中有6只成功复苏，而8只接受高渗盐水治疗的动物中有5只成功复苏。经历20分钟室颤的5只接受碳酸氢盐治疗的猪和5只接受高渗盐水治疗的猪均未复苏。碳酸氢盐治疗组动物的动脉血和混合静脉血pH值与对照组有显著差异。碳酸氢盐治疗组和高渗盐水治疗组动物的收缩压、舒张压或心肌灌注压无差异。
尽管动脉血和静脉血酸血症相关，但使用碳酸氢钠并不能改善长时间心脏骤停后的复苏情况。
