Kühn C, Juchems R, Frese W
Medizinische Klinik, Universität Würzburg, Aschaffenburg, Germany.
Resuscitation. 1991 Dec;22(3):275-82. doi: 10.1016/0300-9572(91)90035-w.
There are two theories to explain the mechanism of blood flow during cardiopulmonary resuscitation: The 'Cardiac Pump Theory' and the 'Thoracic Pump Theory'. We have performed transesophageal echocardiography during the resuscitation of a patient with cardiopulmonary arrest. By this method we could study the motion of the aortic, mitral and tricuspid valves and the changes in ventricular size during cardiopulmonary resuscitation in man. We demonstrated an opening of the aortic valve during thoracic compression with simultaneous closure of the mitral and tricuspid valves. During relaxation of the chest, a rapid opening of the atrioventricular valves and closure of the aortic valve was noted. Short interruption of cardiopulmonary resuscitation to test for spontaneous heart action lead to echocontrast in all four heart chambers through stasis of blood, which resolved on continuation of cardiopulmonary resuscitation. This 'washing out' phenomenon enables visualization of blood flow through the aortic valve during compression, and through the mitral valve during relaxation. These observations favour the Cardiac Pump Theory as the predominant hemodynamic principle of blood flow during cardiopulmonary resuscitation in man.
“心脏泵血理论”和“胸泵理论”。我们在一名心脏骤停患者的复苏过程中进行了经食管超声心动图检查。通过这种方法，我们可以研究人体心肺复苏期间主动脉瓣、二尖瓣和三尖瓣的运动以及心室大小的变化。我们证明在胸外按压期间主动脉瓣开放，同时二尖瓣和三尖瓣关闭。在胸部放松时，注意到房室瓣迅速开放而主动脉瓣关闭。短暂中断心肺复苏以测试自主心跳导致所有四个心腔内血液淤滞产生超声造影，在继续进行心肺复苏后消散。这种“冲洗”现象使得能够观察到按压期间通过主动脉瓣的血流以及放松期间通过二尖瓣的血流。这些观察结果支持心脏泵血理论作为人体心肺复苏期间血流的主要血流动力学原理。
