硝普钠增强心肺复苏术（SNPeCPR）可提高心搏骤停猪模型重要器官灌注压和颈总动脉血流。
Sodium nitroprusside enhanced cardiopulmonary resuscitation (SNPeCPR) improves vital organ perfusion pressures and carotid blood flow in a porcine model of cardiac arrest.
机构信息
Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
出版信息
Resuscitation. 2012 Mar;83(3):374-7. doi: 10.1016/j.resuscitation.2011.07.038. Epub 2011 Aug 22.
PURPOSE OF THE STUDY
To describe a new method of CPR that optimizes vital organ perfusion pressures and carotid blood flow. We tested the hypothesis that a combination of high dose sodium nitroprusside (SNP) as well as non-invasive devices and techniques known independently to enhance circulation would significantly improve carotid blood flow (CBF) and return of spontaneous circulation (ROSC) rates in a porcine model of cardiac arrest.
METHODS
15 isofluorane anesthetized pigs (30±1 kg), after 6 min of untreated ventricular fibrillation, were subsequently randomized to receive either 15 min of standard CPR (S-CPR) (8 animals) or 5 min epochs of S-CPR followed by active compression-decompression (ACD)+inspiratory impedance threshold device (ITD) CPR followed by ACD+ITD+abdominal binding (AB) with 1mg of SNP administered at minutes 2, 7, 12 of CPR (7 animals). Primary endpoints were CBF and ROSC rates. ANOVA and Fisher's exact test were used for comparisons.
RESULTS/CONCLUSION: There was significant improvement in the hemodynamic parameters in the SNP animals. ROSC was achieved in 7/7 animals that received SNP and in 2/8 in the S-CPR (p=0.007). CBF and end tidal CO(2) (ETCO(2)) were significantly higher in the ACD+ITD+AB+SNP (SNPeCPR) animals during CPR. Bolus doses of SNP, when used in conjunction with ACD+ITD+AB CPR, significantly improve CBF and ROSC rates compared to S-CPR.
研究目的
描述一种优化重要器官灌注压和颈动脉血流的新 CPR 方法。我们检验了一个假设，即联合应用大剂量硝普钠（SNP）以及独立已知可增强循环的非侵入性设备和技术，将显著提高心肺复苏（CPR）期间的颈动脉血流（CBF）和自主循环恢复（ROSC）率。
方法
15 只异氟烷麻醉的猪（30±1kg），在未经治疗的心室颤动 6 分钟后，随机分为接受标准 CPR（S-CPR）（8 只动物）或 S-CPR 5 分钟段，随后进行主动压缩-减压（ACD）+吸气阻抗阈值装置（ITD）CPR，随后进行 ACD+ITD+腹部捆绑（AB），在 CPR 的第 2、7、12 分钟给予 1mg SNP（7 只动物）。主要终点是 CBF 和 ROSC 率。使用 ANOVA 和 Fisher's 确切检验进行比较。
结果/结论：SNP 组的血流动力学参数有显著改善。接受 SNP 的 7/7 只动物实现了 ROSC，而 S-CPR 为 2/8（p=0.007）。在 CPR 期间，接受 ACD+ITD+AB+SNP（SNPeCPR）的动物 CBF 和呼气末二氧化碳（ETCO2）显著更高。与 S-CPR 相比，在 ACD+ITD+AB CPR 中联合使用 SNP 时，可显著提高 CBF 和 ROSC 率。
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