Valentino Daniel J, Walter Robert J, Dennis Andrew J, Nagy Kimberly, Loor Michele M, Winners Jerry, Bokhari Faran, Wiley Dorion, Merchant Azher, Joseph Kimberly, Roberts Roxanne
Cook County Trauma Unit, John Stroger Hospital of Cook County, Chicago, IL 60612, USA.
Mil Med. 2008 Feb;173(2):167-73. doi: 10.7205/milmed.173.2.167.
Electromuscular incapacitation (EMI) devices are being used and evaluated by both military and law enforcement agencies. Although the gross muscular response is obvious, physiological responses to these devices are poorly understood. We hypothesized that the intense, repetitive, muscle contractions evoked by EMI devices would cause dose-dependent metabolic acidosis, accompanied by neuromuscular or cardiac injury.
Using an approved protocol, 26 Yucatan mini-pigs (22 experimental animals and 4 control animals) were anesthetized with ketamine and xylazine. Experimental animals were exposed to MK63 (Aegis Industries, Bellevue, Idaho) discharges over the left anterior hind limb for 10, 20, 40, or 80 seconds. Electrocardiograms, electromyograms, troponin I levels, blood gas values, and electrolyte levels were recorded before and 5, 15, 30, and 60 minutes and 24, 48, and 72 hours after discharge. Skin, muscle, and nerve biopsies were taken from the shocked and contralateral sides.
Core body temperature significantly decreased (1.0-1.5 degrees C) in all shocked animals but not in sham-treated control animals. No cardiac dysrhythmias or deaths were seen, and heart rate was unaffected. No clinically significant changes were seen in troponin I, myoglobin, or creatine kinase-MB levels. Central venous blood pH decreased, whereas carbon dioxide pressure and lactate levels increased for 60 minutes after discharge. All values returned to normal by 24 hours after discharge, and no significant histological or electromyographic changes were found.
Changes in blood chemistry were observed but were of little clinical significance, and no neuromuscular damage was detected. Therefore, within the limitations of this model, it appears that EMI can safely be achieved by using this device, even for lengthy periods, without causing significant injury.
军事和执法机构正在使用并评估肌肉电失能(EMI)设备。虽然明显的肌肉总体反应是显而易见的,但对这些设备的生理反应却知之甚少。我们假设,EMI设备诱发的强烈、重复性肌肉收缩会导致剂量依赖性代谢性酸中毒,并伴有神经肌肉或心脏损伤。
按照批准的方案,用氯胺酮和赛拉嗪对26只尤卡坦小型猪(22只实验动物和4只对照动物)进行麻醉。将实验动物左后肢前侧暴露于MK63(爱达荷州贝尔维尤市宙斯盾工业公司生产)放电环境中10、20、40或80秒。在放电前以及放电后5、15、30和60分钟以及24、48和72小时记录心电图、肌电图、肌钙蛋白I水平、血气值和电解质水平。从电击侧和对侧采集皮肤、肌肉和神经活检样本。
所有电击动物的核心体温均显著下降(1.0 - 1.5摄氏度),而假处理的对照动物则未出现这种情况。未观察到心律失常或死亡,心率也未受影响。肌钙蛋白I、肌红蛋白或肌酸激酶 - MB水平未见具有临床意义的变化。放电后60分钟内,中心静脉血pH值下降,而二氧化碳分压和乳酸水平升高。所有值在放电后24小时恢复正常,未发现明显的组织学或肌电图变化。
观察到血液化学成分有变化,但临床意义不大,未检测到神经肌肉损伤。因此,在该模型的局限性范围内,使用该设备似乎可以安全地实现肌肉电失能,即使长时间使用也不会造成重大损伤。