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可卡因中毒对电击枪诱发心室颤动阈值的影响。

Effects of cocaine intoxication on the threshold for stun gun induction of ventricular fibrillation.

作者信息

Lakkireddy Dhanunjaya, Wallick Donald, Ryschon Kay, Chung Mina K, Butany Jagdish, Martin David, Saliba Walid, Kowalewski William, Natale Andrea, Tchou Patrick J

机构信息

Cleveland Clinic Foundation, Cleveland, Ohio, USA.

出版信息

J Am Coll Cardiol. 2006 Aug 15;48(4):805-11. doi: 10.1016/j.jacc.2006.03.055. Epub 2006 Jul 25.

DOI:10.1016/j.jacc.2006.03.055
PMID:16904553
Abstract

OBJECTIVES

This study sought to assess cocaine's effects on Taser-induced ventricular fibrillation (VF) threshold in a pig model.

BACKGROUND

Stun guns are increasingly used by law enforcement officials to restrain violent subjects, who are frequently intoxicated with cocaine and other drugs of abuse. The interaction of cocaine and the stun gun on VF induction is unknown.

METHODS

We tested five adult pigs using a custom device built to deliver multiples of standard neuromuscular incapacitating (NMI) discharge that matched the waveform of a commercially available electrical stun gun (Taser X-26, Taser International, Scottsdale, Arizona). The NMI discharges were applied in a step-up and step-down fashion at 5 body locations. End points included determination of maximum safe multiple, minimum VF-inducing multiple, and ventricular fibrillation threshold (VFT) before and after cocaine infusion.

RESULTS

Standard NMI discharges (x1) did not cause VF at any of the 5 locations before or after cocaine infusion. The maximum safe multiple, minimum VF-inducing multiple, and VFT of NMI application increased with increasing electrode distance from the heart. There was a 1.5- to 2-fold increase in these values at each position after cocaine infusion, suggesting decreased cardiac vulnerability for VF. Cocaine increased the required strength of NMI discharge that caused 2:1 or 3:1 ventricular capture ratios at all of the positions. No significant changes in creatine kinase-MB and troponin-I were seen.

CONCLUSIONS

Cocaine increased the VFT of NMI discharges at all dart locations tested and reduced cardiac vulnerability to VF. The application of cocaine increased the safety margin by 50% to 100% above the baseline safety margin.

摘要

目的

本研究旨在评估可卡因对猪模型中泰瑟枪诱发心室颤动(VF)阈值的影响。

背景

执法人员越来越多地使用电击枪来制服暴力对象,这些对象经常吸食可卡因和其他滥用药物。可卡因与电击枪对心室颤动诱发的相互作用尚不清楚。

方法

我们使用定制设备对5只成年猪进行测试,该设备可提供与市售电击枪(泰瑟X-26,泰瑟国际公司,亚利桑那州斯科茨代尔)波形匹配的标准神经肌肉失能(NMI)放电倍数。NMI放电以逐步增加和逐步降低的方式应用于5个身体部位。终点包括确定最大安全倍数、最小诱发VF倍数以及可卡因输注前后的心室颤动阈值(VFT)。

结果

标准NMI放电(x1)在可卡因输注前后的任何5个部位均未诱发VF。NMI应用的最大安全倍数、最小诱发VF倍数和VFT随着电极与心脏距离的增加而增加。可卡因输注后,每个位置的这些值增加了1.5至2倍,表明心脏对VF的易损性降低。可卡因增加了在所有位置导致2:1或3:1心室捕获率所需的NMI放电强度。肌酸激酶-MB和肌钙蛋白-I未见明显变化。

结论

可卡因增加了所有测试飞镖位置的NMI放电的VFT,并降低了心脏对VF的易损性。可卡因的应用使安全裕度比基线安全裕度提高了50%至100%。

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