Pediatric Intensive Care Service, Hospital General Universitario Gregorio Marañón, Dr Castelo 47, 28009, Madrid, Spain.
Intensive Care Med. 2010 Apr;36(4):712-6. doi: 10.1007/s00134-010-1777-9. Epub 2010 Feb 11.
To compare the ventilation achieved with chest compressions (CC) or ventilation plus compressions (VC) in a pediatric animal model of cardiac arrest.
Randomized experimental study.
Experimental department of a University Hospital.
Twelve infant pigs with asphyxial cardiac arrest. Sequential 3-min periods of VC and CC were performed for a total duration of 9 min. Tidal volume (TV), end-tidal CO(2) (EtCO(2)), mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary arterial pressure (mPAP), and peripheral, cerebral, and renal saturations were recorded and arterial and venous blood gases were analyzed.
VC achieved a TV similar to the preset parameters on the ventilator, whilst the TV in CC was very low (P < 0.001). EtCO(2) with VC was significantly higher than with CC (14.0 vs. 3.9 mmHg, P < 0.05). Arterial pH was higher with VC than with CC (6.99 vs. 6.90 mmHg, P < 0.05). Arterial PCO(2) was lower with VC than with CC (62.1 vs. 97.0 mmHg, P < 0.05). There were no significant differences in the MAP; CVP; mPAP; peripheral, renal, and cerebral saturations; or lactate concentrations between the two techniques.
VC achieves better ventilation than CC during cardiopulmonary resuscitation and has no negative effect on the hemodynamic situation.
比较心肺复苏时单纯按压(CC)与按压加通气(VC)的通气效果,动物模型为窒息性心跳骤停的儿科患者。
随机对照实验研究。
某大学附属医院的实验部门。
采用 12 只窒息性心跳骤停的仔猪作为研究对象,行 VC 与 CC 序贯通气,各持续 3 分钟,共 9 分钟。记录潮气量(TV)、呼气末二氧化碳(EtCO2)、平均动脉压(MAP)、中心静脉压(CVP)、平均肺动脉压(mPAP)、外周、脑、肾饱和度,分析血气。
VC 可达到预设的呼吸机参数水平,而 CC 的 TV 非常低(P<0.001)。VC 的 EtCO2 显著高于 CC(14.0 比 3.9 mmHg,P<0.05)。VC 的动脉 pH 高于 CC(6.99 比 6.90 mmHg,P<0.05)。VC 的动脉 PCO2 低于 CC(62.1 比 97.0 mmHg,P<0.05)。两种技术之间 MAP、CVP、mPAP、外周、肾、脑饱和度或乳酸浓度无显著差异。
在心肺复苏时,VC 比 CC 能提供更好的通气效果,且对血流动力学无负面影响。