Spence P A, Lust R M, Chitwood W R, Iida H, Sun Y S, Austin E H
Department of Cardiac Surgery, East Carolina University School of Medicine, Greenville, North Carolina 27858-4354.
J Surg Res. 1990 Sep;49(3):217-21. doi: 10.1016/0022-4804(90)90122-i.
These experiments were designed to determine whether the limited cardiac output during open cardiac massage could be preferentially directed to the coronary and cerebral vessels by balloon occlusion of the descending thoracic aorta. Sixteen dogs were instrumented to monitor cardiac output and left atrial, right atrial, right ventricular, left ventricular, and arterial blood pressures. Measurements of myocardial and cerebral blood flow distribution during massage were made using the radioactive microsphere technique. Each animal underwent two episodes of fibrillation and resuscitation. In one episode the arrest was managed by open massage alone, and in the other, open massage was accompanied by balloon occlusion, with the order randomized. When compared to control, open cardiac massage was associated with a significant decrease in mean arterial pressure; however, the addition of balloon occlusion produced a 130% increase in the mean arterial pressure that was obtained during open CPR (control, 93 +/- 5 mm Hg; massage alone, 35 +/- 2 mm Hg; massage + balloon, 76 +/- 2 mm Hg, P less than 0.01). In a similar fashion, although the absolute blood flow was reduced by 50% when compared to control, the blood flow (ml/min/g) to the brain and heart during massage was 100% better when balloon occlusion was employed (brain: control, 0.41 +/- 0.03; massage only, 0.05 +/- 0.01; massage + balloon, 0.25 +/- 0.02, P less than 0.01; heart: control, 1.46 +/- 0.11; massage alone, 0.35 +/- 0.05; massage + balloon, 0.71 +/- 0.05, P less than 0.01). These results suggest that aortic occlusion significantly increased myocardial and cerebral perfusion patterns during ventricular fibrillation and open cardiac massage.(ABSTRACT TRUNCATED AT 250 WORDS)
这些实验旨在确定在开胸心脏按压期间，通过球囊阻断胸降主动脉，有限的心输出量是否能优先导向冠状动脉和脑血管。对16只狗进行仪器安装，以监测心输出量以及左心房、右心房、右心室、左心室和动脉血压。在按压期间，使用放射性微球技术测量心肌和脑血流分布。每只动物经历两次心室颤动和复苏过程。在一次过程中，仅通过开胸按压进行心脏骤停处理，而在另一次过程中，开胸按压伴有球囊阻断，顺序随机。与对照组相比，开胸心脏按压导致平均动脉压显著降低；然而，添加球囊阻断使开胸心肺复苏期间获得的平均动脉压增加了130%（对照组，93±5 mmHg；仅按压，35±2 mmHg；按压+球囊，76±2 mmHg，P<0.01）。以类似方式，尽管与对照组相比绝对血流量减少了50%，但在采用球囊阻断时，按压期间流向脑和心脏的血流量（ml/min/g）要好100%（脑：对照组，0.41±0.03；仅按压，0.05±0.01；按压+球囊，0.25±0.02，P<0.01；心脏：对照组，1.46±0.11；仅按压，0.35±0.05；按压+球囊，0.71±0.05，P<0.01）。这些结果表明，在心室颤动和开胸心脏按压期间，主动脉阻断显著增加了心肌和脑灌注模式。（摘要截短至250字）
