Lewis L M, Stothert J C, Kraus G E, Gomez C R, Goodgold H, Keltner R M, Ashley K, Fortney J P
Emergency Department, St. Louis University Hospital, Missouri 63110-0250.
Resuscitation. 1990 Dec;20(3):213-20. doi: 10.1016/0300-9572(90)90004-x.
We have previously utilized the technique of transcranial Doppler (TCD) ultrasound to determine cerebral perfusion in patients undergoing cardiopulmonary resuscitation (CPR). In order to assess if TCD can reliably measure alterations in cerebral perfusion under conditions of normal and low cardiac outputs, we compared TCD measured blood flow velocities in the middle cerebral artery (MCA) of six piglets with radioactive microsphere determinations of total cerebral perfusion at baseline normal sinus rhythm (NSR), during CPR, and following return of spontaneous circulation (ROSC). Peak systolic and mean blood flow velocities were compared to the microsphere perfusion results on 15 different occasions; six during NSR, five during CPR, and four following ROSC. Although qualitative alterations in TCD measurements reflected changes in microsphere perfusion, we could not find a statistically significant correlation between either peak systolic or mean MCA blood flow velocities and microsphere perfusion measurements either overall or in any subgroup. The possible reasons which may explain the findings are discussed.
我们之前已运用经颅多普勒（TCD）超声技术来测定接受心肺复苏（CPR）患者的脑灌注情况。为评估TCD能否在正常心输出量和低心输出量条件下可靠地测量脑灌注变化，我们比较了6只仔猪大脑中动脉（MCA）经TCD测量的血流速度与通过放射性微球测定的在基线正常窦性心律（NSR）、心肺复苏期间及自主循环恢复（ROSC）后总的脑灌注情况。在15个不同时间点比较了收缩期峰值血流速度和平均血流速度与微球灌注结果；正常窦性心律时有6次，心肺复苏期间有5次，自主循环恢复后有4次。尽管TCD测量的定性变化反映了微球灌注的变化，但我们未发现收缩期峰值或大脑中动脉平均血流速度与微球灌注测量值在总体上或任何亚组中有统计学显著相关性。文中讨论了可能解释这些发现的原因。
