Goetting M G, Contreras E
Department of Pediatrics, Henry Ford Hospital, Detroit, Michigan 48202.
Ann Emerg Med. 1991 Jan;20(1):55-7. doi: 10.1016/s0196-0644(05)81119-9.
Systemic administration of atropine during CPR may postpone brain death determination because of its reputed ability to produce fixed and dilated pupils. We studied the effect of atropine administered in the usual doses as an adjunct to endotracheal intubation and for cardiac arrest to determine if it would interfere with neurological assessment.
Two groups of children were studied. Group 1 consisted of 28 patients who received atropine (0.03 +/- 0.003 mg/kg) prior to endotracheal intubation. Group 2 consisted of 21 patients previously without evidence of brainstem disease who suffered a witnessed arrest and had prompt return of spontaneous circulation and received an atropine dose of 0.03 +/- 0.01 mg/kg.
In group 1, pupillary size averaged 4.02 +/- 0.78 mm before and 4.75 mm +/- .84 mm after atropine (P less than .001). In group 2, the pupillary examination was conducted 30 minutes after return of spontaneous circulation. The pupillary diameter was 4.80 +/- 0.91 mm. All pupils were reactive to light in both groups.
Atropine administration in conventional dose causes slight pupillary dilation but does not abolish pupillary light reactivity.
在心肺复苏期间全身应用阿托品可能会推迟脑死亡的判定，因为其据称有使瞳孔固定和散大的能力。我们研究了以常规剂量给予阿托品作为气管插管辅助用药及用于心脏骤停时的效果，以确定其是否会干扰神经学评估。
对两组儿童进行了研究。第1组由28例在气管插管前接受阿托品（0.03±0.003毫克/千克）的患者组成。第2组由21例先前无脑干疾病证据、发生了目击心脏骤停且迅速恢复自主循环并接受了0.03±0.01毫克/千克阿托品剂量的患者组成。
在第1组中，阿托品应用前瞳孔平均大小为4.02±0.78毫米，应用后为4.75±0.84毫米（P<0.001）。在第2组中，在自主循环恢复30分钟后进行瞳孔检查。瞳孔直径为4.80±0.91毫米。两组所有瞳孔对光均有反应。
以常规剂量应用阿托品会导致轻微瞳孔散大，但不会消除瞳孔对光反应。
