Tyson A A, Sundberg D K, Sayers D G, Ober K P, Snow R E
Department of Medicine, North Carolina Baptist Hospital, Bowman Gray School of Medicine, Winston-Salem, NC 27103.
Am J Emerg Med. 1988 Sep;6(5):435-8. doi: 10.1016/0735-6757(88)90240-9.
Fourteen patients with either acute myocardial infarction or unstable angina pectoris were transported by helicopter air ambulance to North Carolina Baptist Hospital during a 1-month period. Six patients had preflight and inflight plasma epinephrine and norepinephrine levels determined. All 14 patients were monitored for ventricular arrhythmias. The mean inflight plasma epinephrine level was significantly higher than the mean preflight level (3455 v 841 pg/mL, P less than .005). There was also a trend toward higher inflight norepinephrine levels; however, this increase was not statistically significant. No patient had a monitored ventricular arrhythmia. These findings suggest that helicopter transport of cardiac patients may be associated with significant patient stress, as reflected by high inflight catecholamine levels. Further study with a larger population of patients is needed to determine whether or not an increased incidence of inflight ventricular arrhythmias is associated with these catecholamine changes.
在1个月的时间里，14例急性心肌梗死或不稳定型心绞痛患者通过直升机空中救护车被转运至北卡罗来纳浸信会医院。6例患者在飞行前和飞行中测定了血浆肾上腺素和去甲肾上腺素水平。对所有14例患者进行了室性心律失常监测。飞行中血浆肾上腺素的平均水平显著高于飞行前水平（3455对841 pg/mL，P<0.005）。飞行中去甲肾上腺素水平也有升高的趋势；然而，这种升高在统计学上并不显著。没有患者监测到室性心律失常。这些发现表明，心脏病患者的直升机转运可能与患者明显的应激有关，飞行中儿茶酚胺水平升高反映了这一点。需要对更多患者进行进一步研究，以确定飞行中室性心律失常发生率的增加是否与这些儿茶酚胺变化有关。
