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对疲惫的人长时间使用泰瑟枪不会使酸中毒指标恶化。

Prolonged TASER use on exhausted humans does not worsen markers of acidosis.

作者信息

Ho Jeffrey D, Dawes Donald M, Bultman Laura L, Moscati Ronald M, Janchar Timothy A, Miner James R

机构信息

Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN 55415, USA.

出版信息

Am J Emerg Med. 2009 May;27(4):413-8. doi: 10.1016/j.ajem.2008.03.017.

Abstract

OBJECTIVE

There are safety concerns about TASER conducted electrical weapon (CEW) use on humans, and there have been media reports of adverse human outcomes after CEW exposure. Conducted electrical weapons are often used on physically exhausted subjects. A single CEW application of a CEW is generally accepted to be 5 seconds of exposure. Some exposures in reality involve more than 5 seconds. We sought to determine if a prolonged (15 seconds) CEW exposure on exhausted humans caused acidosis, hyperkalemia, serum lactate change, or troponin change.

METHODS

This was a prospective study of generally healthy human volunteers. Medical histories and baseline serum values were obtained, and several of the volunteers did have acute or chronic medical problems. Subjects underwent an exercise protocol until subjective exhaustion. Exhaustion was defined by the volunteer no longer being able to perform the exercise at a given pace. Blood was drawn immediately (defined as within 20 seconds) after exercise and was immediately followed by a 15-second CEW exposure. Blood was drawn immediately after exposure and again at 16 to 24 hours after exposure. Blood was analyzed for pH, pco(2), potassium, lactate, and troponin. Data were compared using Wilcoxon signed rank tests.

RESULTS

There were 38 subjects enrolled with an average age of 39 years. The following health conditions were reported among the volunteers: hypertension (2), gastritis/reflux (2), active respiratory tract infections (3), asthma (2), chronic muscular pain conditions (4), pituitary adenoma (1) and glaucoma (1). Sixteen volunteers reported use of prescription medication at the time of their participation. The median initial pH of 7.38 (interquartile range [IQR], 7.35-7.40) decreased to 7.23 (IQR, 7.19-7.31) immediately after exercise. Immediately after exposure, median pH was 7.22 (IQR, 7.18-7.25). It was 7.39 (IQR, 7.37-7.43) at 24 hours. The pCO2 increased from 46.3 (IQR, 43.0-54.5) to 57.4 (IQR, 49.9-67.7) immediately after exercise, decreased to 51.3 (IQR, 44.4-65.0) immediately after exposure, and was 46.3 (IQR, 42.7-51.7) at 24 hours. Lactate increased from a median of 1.65 (IQR, 1.14-2.55) to 8.39 (IQR, 6.98-11.66) immediately after exercise, increased to 9.85 (IQR, 7.70-12.87) immediately after exposure, and was 1.02 (IQR, 0.91-1.57) at 24 hours. Serum potassium increased from 3.9 (IQR, 3.8-4.4) to 4.2 (IQR, 4.0-4.9) immediately after exercise, decreased to 3.8 (IQR, 3.7-4.4) immediately after exposure, and was 4.1 (IQR, 3.9-4.6) at 24 hours. No troponin elevations were detected.

CONCLUSION

Prolonged CEW application on exhausted humans was not associated with worsening change in pH or troponin. Decreases in pCO2 and potassium and a small increase in lactate were found. Worsening acidosis theories due to CEW use in this population are not supported by these data.

摘要

目的

人们对泰瑟电击武器(CEW)用于人体存在安全担忧,且有媒体报道称接触CEW后出现了不良人体后果。电击武器常用于身体疲惫的对象。通常认为单次使用CEW的暴露时间为5秒。而实际中有些暴露时间超过5秒。我们试图确定对疲惫的人体进行延长(15秒)的CEW暴露是否会导致酸中毒、高钾血症、血清乳酸变化或肌钙蛋白变化。

方法

这是一项针对一般健康人类志愿者的前瞻性研究。获取了他们的病史和基线血清值,部分志愿者确实存在急性或慢性疾病问题。受试者进行运动方案直至主观疲惫。疲惫的定义是志愿者无法再以给定的速度进行运动。运动后立即(定义为20秒内)采血,随后立即进行15秒的CEW暴露。暴露后立即采血,并在暴露后16至24小时再次采血。对血液进行pH、pco(2)、钾、乳酸和肌钙蛋白分析。使用Wilcoxon符号秩检验比较数据。

结果

共招募了38名受试者,平均年龄39岁。志愿者中报告了以下健康状况:高血压(2例)、胃炎/反流(2例)、活动性呼吸道感染(3例)、哮喘(2例)、慢性肌肉疼痛疾病(4例)、垂体腺瘤(1例)和青光眼(1例)。16名志愿者报告在参与研究时正在使用处方药。运动后初始pH中位数7.38(四分位间距[IQR],7.35 - 7.40)立即降至7.23(IQR,7.19 - 7.31)。暴露后立即,pH中位数为7.22(IQR,7.18 - 7.25)。24小时时为7.39(IQR,7.37 - 7.43)。运动后pCO2从46.3(IQR,43.0 - 54.5)升至57.4(IQR,49.9 - 67.7),暴露后立即降至51.3(IQR,44.4 - 65.0),24小时时为46.3(IQR,42.7 - 51.7)。乳酸从运动后中位数1.65(IQR,1.14 - 2.55)升至8.39(IQR,6.98 - 11.66),暴露后立即升至9.85(IQR,7.70 - 12.87),24小时时为1.02(IQR,0.91 - 1.57)。未检测到肌钙蛋白升高。

结论

对疲惫的人体延长使用CEW与pH或肌钙蛋白的恶化变化无关。发现pCO2和钾降低,乳酸略有增加。这些数据不支持该人群中因使用CEW导致酸中毒恶化的理论。

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