Wu Bingjing, Peng Yong G, Zhao Shishi, Bao Nana, Pan Linmin, Dong Jiaojiao, Xu Xuzhong, Wang Quanguang
Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China.
Department of Anesthesiology, College of Medicine, University of Florida Shands Hospital, Gainesville, FL, USA.
BMC Anesthesiol. 2017 Feb 2;17(1):18. doi: 10.1186/s12871-017-0309-3.
Levosimendan exerted favorable effects on the initial outcome in the treatment of ventricular fibrillation cardiac arrest. This study investigated the efficacy of levosimendan in the treatment of asphyxia-induced cardiac arrest in rats.
Animals underwent asphyxial cardiac arrest/cardiopulmonary resuscitation, randomized to three treatment groups: epinephrine (10 μg/kg) supplemented with levosimendan (bolus 12 μg/kg and infusion for 1 h, EL group); epinephrine only (10 μg/kg, E group), or levosimendan only (bolus 12 μg/kg and infusion for 1 h, L group). The resuscitation success rate, wet-to-dry ratio of lung, and rate of alveolar and blood gas analysis were recorded.
10 rats in the EL group, 8 in the E group, and 2 in the L group showed an initial return of spontaneous circulation (P < 0.001); among them, 10, 4, and 2 rats survived at the end of a 60-min observation period from each group, respectively (P = 0.001). The coronary perfusion pressure in the EL group was higher than that of either the E or L group (P < 0.05). The lung wet-to-dry weight ratio and rate of damaged alveoli were lower in the EL group than the E group (P < 0.05).
In the early stage of resuscitation for asphyxia-induced cardiac arrest in rats, levosimendan supplemented with epinephrine can significantly increase coronary perfusion pressure, reduce lung injury, and ultimately enhance the survival rate.
左西孟旦对室颤性心脏骤停的初始治疗效果良好。本研究探讨左西孟旦治疗大鼠窒息性心脏骤停的疗效。
动物经历窒息性心脏骤停/心肺复苏，随机分为三个治疗组：肾上腺素（10μg/kg）联合左西孟旦（静脉推注12μg/kg并输注1小时，EL组）；仅用肾上腺素（10μg/kg，E组），或仅用左西孟旦（静脉推注12μg/kg并输注1小时，L组）。记录复苏成功率、肺湿干比以及肺泡和血气分析结果。
EL组10只大鼠、E组8只大鼠、L组2只大鼠出现初始自主循环恢复（P<0.001）；其中，每组分别有10只、4只和2只大鼠在60分钟观察期结束时存活（P=0.001）。EL组的冠状动脉灌注压高于E组和L组（P<0.05）。EL组的肺湿干重比和肺泡损伤率低于E组（P<0.05）。
在大鼠窒息性心脏骤停复苏的早期阶段，肾上腺素联合左西孟旦可显著提高冠状动脉灌注压，减轻肺损伤，并最终提高生存率。
