Ripeckyj Adrian, Kosmopoulos Marinos, Shekar Kadambari, Carlson Claire, Kalra Rajat, Rees Jennifer, Aufderheide Tom P, Bartos Jason A, Yannopoulos Demetris
Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota.
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
JACC Basic Transl Sci. 2020 Feb 5;5(2):183-192. doi: 10.1016/j.jacbts.2019.11.010. eCollection 2020 Feb.
Sodium nitroprusside-enhanced cardiopulmonary resuscitation has shown superior resuscitation rates and neurologic outcomes in large animal models supporting the need for a randomized human clinical trial. This study is the first to show nonselective pulmonary vasodilation as a potential mechanism for the hemodynamic benefits. The pulmonary shunting that is created requires increased oxygen treatment, but the overall improvement in blood flow increases minute oxygen delivery to tissues. In this context, hypoxemia is an important safety endpoint and a 100% oxygen ventilation strategy may be necessary for the first human clinical trial.
硝普钠强化心肺复苏在大型动物模型中已显示出更高的复苏率和神经学预后,这支持了开展随机人体临床试验的必要性。本研究首次表明非选择性肺血管舒张是血流动力学获益的潜在机制。由此产生的肺内分流需要增加氧疗,但血流的整体改善增加了每分钟向组织输送的氧量。在此背景下,低氧血症是一个重要的安全终点,首次人体临床试验可能需要采用100%氧通气策略。