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复苏技术及心脏骤停前氧合状态对犬心肺复苏期间血气值的影响。

The effect of resuscitation technique and pre-arrest state of oxygenation on blood-gas values during cardiopulmonary resuscitation in dogs.

作者信息

Lippert A C, Evans A T, White B C, Eyster G E

机构信息

Department of Small Animal Clinical Sciences, Michigan State University, East Lansing 48824-1314.

出版信息

Vet Surg. 1988 Sep-Oct;17(5):283-90. doi: 10.1111/j.1532-950x.1988.tb01018.x.

Abstract

Large mongrel dogs were anesthetized, instrumented, and subjected to electrically induced ventricular fibrillation after breathing either 100% oxygen (O2) or 10% O2 and 90% nitrogen for 10 minutes before arrest. Four minutes after arrest, open chest cardiopulmonary resuscitation (CPR) or intermittent abdominal compression closed chest CPR was initiated and continued for 20 minutes, at which time defibrillation was attempted. Central arterial and mixed venous blood samples were collected serially for the measurement of pH, carbon dioxide partial pressure (PCO2), and O2 partial pressure (PO2), and calculation of bicarbonate concentration and base excess. Mixed venous blood was collected serially for the measurement of lactate concentration. Hemodynamically variable resuscitation techniques and pre-arrest hypoxia or hyperoxia did not significantly influence blood-gas values during CPR. Mixed venous lactate concentrations after 20 minutes of CPR were significantly higher when hypoxia preceded the arrest and when intermittent abdominal compression closed chest CPR was used for resuscitation. Mixed venous PCO2 was significantly higher than arterial PCO2 in all dogs during CPR but was not significantly different before arrest.

摘要

大型杂种犬接受麻醉、安装监测仪器,在心跳骤停前分别吸入100%氧气(O₂)或10% O₂与90%氮气10分钟,之后诱发心室颤动。心跳骤停4分钟后,开始进行开胸心肺复苏(CPR)或间断腹部按压的闭胸CPR,并持续20分钟,此时尝试进行除颤。连续采集中心动脉血和混合静脉血样本,用于测量pH值、二氧化碳分压(PCO₂)和氧分压(PO₂),并计算碳酸氢盐浓度和碱剩余。连续采集混合静脉血用于测量乳酸浓度。血流动力学可变的复苏技术以及心跳骤停前的低氧或高氧状态对CPR期间的血气值没有显著影响。当心跳骤停前存在低氧状态以及使用间断腹部按压的闭胸CPR进行复苏时,CPR 20分钟后的混合静脉乳酸浓度显著更高。CPR期间,所有犬的混合静脉PCO₂均显著高于动脉PCO₂,但在心跳骤停前无显著差异。

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