Kunz S N, Calkins H G, Adamec J, Kroll M W
Department of Forensic Pathology, Landspítali University Hospital, v/Barónsstíg, 101, Reykjavik, Iceland.
Johns Hopkins Medical Institutions, Baltimore, USA.
Int J Legal Med. 2018 Sep;132(5):1469-1475. doi: 10.1007/s00414-018-1771-2. Epub 2018 Jan 19.
Electronic control with the CEW (conducted electrical weapon) has gained widespread acceptance as the preferred force option due to its significant injury reduction. However, a CEW application does stress the human body. In the case of the CEW, the human body response is similar to the challenge of physical exercise combined with emotional stress over a very short time interval. There has been concern whether the tension of the skeletal-muscle system together with the emotional stress of being exposed to the effects of a CEW, can lead to severe metabolic dysfunction.
A systematic and careful search of the MedLine database was performed to find publications describing pathophysiological effects of CEWs. Additional publications were collected through a manual search of reference lists in retrieved articles. After preliminary exclusions, we carefully reviewed the remaining publications and found 24 papers reporting prospective human clinical research data on adrenergic, ventilation, or metabolic effects. Where there were multiple studies on the same endpoints, we performed meta-analyses.
A CEW exposure provides a clinically insignificant increase in heart rate (7.5 BPM) and a drop in both systolic and diastolic blood pressure. Alpha-amylase goes down but cortisol levels increase-both epinephrine and norepinephrine levels are increased by levels similar to mild exercise. A CEW exposure increases ventilation but does not appear to interfere with gas exchange. Lactate is increased slightly while the pH is decreased slightly with changes equivalent to mild exercise. The lactate and pH changes appear quickly and do not appear to be affected by increasing the exposure duration from 5 to 30 s.
Thorough review and meta-analyses show that electrical weapon exposures have mixed and mild adrenergic effects. Ventilation is increased and there are metabolic changes similar to mild exercise.
由于电击枪（CEW，传导性电子武器）能显著减少伤害，其电子控制已作为首选武力选项获得广泛认可。然而，电击枪的使用确实会对人体造成压力。就电击枪而言，人体反应类似于在极短时间内进行体育锻炼并承受情绪压力的挑战。人们一直担心，骨骼肌系统的紧张以及暴露于电击枪影响下的情绪压力，是否会导致严重的代谢功能障碍。
对MedLine数据库进行了系统而仔细的检索，以查找描述电击枪病理生理效应的出版物。通过人工检索所检索文章中的参考文献列表收集了其他出版物。在初步排除后，我们仔细审查了其余的出版物，发现有24篇论文报告了关于肾上腺素能、通气或代谢效应的前瞻性人体临床研究数据。对于同一终点有多项研究的情况，我们进行了荟萃分析。
暴露于电击枪会使心率临床意义不大地增加（7.5次/分钟），收缩压和舒张压均下降。α-淀粉酶水平下降，但皮质醇水平升高——肾上腺素和去甲肾上腺素水平的升高幅度与轻度运动时相似。暴露于电击枪会增加通气，但似乎不会干扰气体交换。乳酸水平略有升高，而pH值略有下降，变化程度与轻度运动相当。乳酸和pH值的变化出现得很快，且似乎不受将暴露持续时间从5秒增加到30秒的影响。
全面审查和荟萃分析表明，电击枪暴露具有混合且轻微的肾上腺素能效应。通气增加，且存在与轻度运动相似的代谢变化。
