Sanders A B, Otto C W, Kern K B, Rogers J N, Perrault P, Ewy G A
Department of Surgery, University of Arizona Health Sciences Center, Tucson 85724.
Ann Emerg Med. 1988 Jul;17(7):667-71. doi: 10.1016/s0196-0644(88)80606-1.
Our study was performed to determine the pattern of arterial, venous, and cerebral spinal fluid (CSF) acidosis in a canine model of cardiac arrest and resuscitation; and the effect of bicarbonate treatment on arterial, venous, and CSF acidosis. Animals were instrumented to sample arterial blood, mixed venous blood, and CSF through a cisternal catheter. Following six minutes of ventricular fibrillation, manual CPR efforts were begun and continued for 30 minutes of cardiac arrest. Arterial, mixed venous, and CS fluids were sampled at baseline, six, 12, 18, 24, 27, and 30 minutes. Ten experimental dogs received sodium bicarbonate (2 mEq/kg) at 20 minutes of cardiac arrest, while ten animals in the control group received no alkali treatment. The experimental group showed a significantly higher arterial (7.79 +/- 0.20 vs 7.46 +/- 0.16 at 30 minutes) and venous pH (7.34 +/- 0.12 vs 7.19 +/- 0.10 at 24 minutes) following bicarbonate administration. This higher pH occurred despite a concomitant increase in arterial (31 +/- 10 vs 19 +/- 9 mm Hg at 27 minutes; 31 +/- 9 vs 10 +/- 8 at 30 minutes) and venous (104 +/- 30 vs 63 +/- 10 mm Hg at 24 minutes) pCO2. CSF analysis showed a gradually worsening acidosis. However, CSF pH (7.12 +/- 0.14 vs 7.16 +/- 0.23 at 30 minutes) and pCO2 were not significantly changed by the administration of bicarbonate.
我们进行这项研究是为了确定心脏骤停和复苏犬模型中的动脉、静脉及脑脊液（CSF）酸中毒模式；以及碳酸氢盐治疗对动脉、静脉和脑脊液酸中毒的影响。对动物进行仪器植入，以便通过脑池导管采集动脉血、混合静脉血和脑脊液。在心室颤动6分钟后，开始进行手动心肺复苏，并持续30分钟心脏骤停。在基线、第6、12、18、24、27和30分钟采集动脉、混合静脉和脑脊液样本。10只实验犬在心脏骤停20分钟时接受碳酸氢钠（2 mEq/kg）治疗，而对照组的10只动物未接受碱性治疗。给药后，实验组的动脉pH值（30分钟时为7.79±0.20，而对照组为7.46±0.16）和静脉pH值（24分钟时为7.34±0.12，而对照组为7.19±0.10）显著升高。尽管动脉（27分钟时为31±10 vs 19±9 mmHg；30分钟时为31±9 vs 10±8）和静脉（24分钟时为104±30 vs 63±10 mmHg）的pCO2同时升高，但仍出现了较高的pH值。脑脊液分析显示酸中毒逐渐加重。然而，碳酸氢盐给药并未显著改变脑脊液的pH值（30分钟时为7.12±0.14，而对照组为7.16±0.23）和pCO2。
