Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA.
Crit Care Med. 2010 Mar;38(3):916-21. doi: 10.1097/CCM.0b013e3181cd1291.
We have previously demonstrated that nasopharyngeal cooling initiated during cardiopulmonary resuscitation improves the success of resuscitation. In this study, we compared the effects of nasopharyngeal cooling with cold saline infusion initiated during cardiopulmonary resuscitation on resuscitation outcome in a porcine model of prolonged cardiac arrest. We hypothesized that nasopharyngeal cooling initiated during cardiopulmonary resuscitation would yield better resuscitation outcome when compared with cold saline infusion.
Randomized, prospective animal study.
University-affiliated research laboratory.
Yorkshire-X domestic pigs (Sus scrofa).
Ventricular fibrillation was induced in 14 pigs weighing 38 +/- 2 kg. After 15 mins of untreated ventricular fibrillation, cardiopulmonary resuscitation was performed for 5 mins before defibrillation. Coincident with the start of cardiopulmonary resuscitation, animals were randomly assigned to receive nasopharyngeal cooling with the aid of the RhinoChill Device (BeneChill, San Diego, CA) or cold saline infusion with 30 mL/kg 4 degrees C saline. One hour after restoration of spontaneous circulation, surface cooling was begun with the aid of a water blanket in both groups and maintained for 4 hrs.
Jugular vein temperature significantly decreased in animals subjected to nasopharyngeal cooling in comparison with those receiving cold saline infusion (p < .01). Core temperature, however, decreased only in animals receiving cold saline infusion (p < .01). Coronary perfusion pressure was significantly higher in the animals treated with nasopharyngeal cooling (p = .02). All seven animals treated with nasopharyngeal cooling were successfully resuscitated in contrast to only two animals resuscitated in the cold saline infusion group (p = .02).
In this model, nasopharyngeal cooling initiated during cardiopulmonary resuscitation improved the success of resuscitation compared to cooling with cold saline infusion.
我们之前已经证明，心肺复苏期间开始的鼻咽部冷却可提高复苏的成功率。在这项研究中，我们比较了心肺复苏期间开始的鼻咽部冷却与冷生理盐水输注对长时间心脏骤停的猪模型复苏结果的影响。我们假设，与冷生理盐水输注相比，心肺复苏期间开始的鼻咽部冷却会产生更好的复苏结果。
随机、前瞻性动物研究。
大学附属研究实验室。
约克夏- X 家猪（Sus scrofa）。
在 14 只体重为 38 +/- 2 kg 的猪中诱发心室颤动。未经处理的心室颤动 15 分钟后，进行心肺复苏 5 分钟，然后除颤。与心肺复苏开始同时，动物随机分为接受 RhinoChill 装置（BeneChill，圣地亚哥，CA）辅助的鼻咽部冷却或 4 度 C 生理盐水 30 mL/kg 的冷生理盐水输注。自主循环恢复后 1 小时，两组均使用水毯开始体表冷却，并持续 4 小时。
与接受冷生理盐水输注的动物相比，接受鼻咽部冷却的动物的颈内静脉温度显著降低（p <.01）。然而，只有接受冷生理盐水输注的动物的核心温度降低（p <.01）。接受鼻咽部冷却治疗的动物的冠状动脉灌注压明显较高（p =.02）。与仅在冷生理盐水输注组中复苏的 2 只动物相比，用鼻咽部冷却治疗的 7 只动物全部成功复苏（p =.02）。
在该模型中，与冷生理盐水输注相比，心肺复苏期间开始的鼻咽部冷却可提高复苏的成功率。
