Hausknecht M J, Wise R A, Brower R G, Hassapoyannes C, Weisfeldt M L, Suzuki J, Permutt S
Circ Res. 1986 Dec;59(6):676-83. doi: 10.1161/01.res.59.6.676.
Using an isolated, fibrillated canine heart-lung preparation, we studied the effects of simultaneous lung inflation and chest compression on blood flow in a model of cardiopulmonary resuscitation. The heart and lungs were placed in an artificial thorax with the great vessels and trachea exteriorized and attached to an artificial perfusion circuit and respirator, respectively. The blood volume of the system was adjusted to obtain various levels of static equilibrium pressure. Blood flow was obtained by cyclically raising and lowering the pressure in the artificial thorax, simulating the changes in pleural pressure that occur during cardiopulmonary resuscitation. Lung inflation during the compression phase caused an increase in cardiopulmonary resuscitation blood flow when the change in pleural pressure was small and when static equilibrium pressure was high. In contrast, lung inflation caused a decrease in blood flow when changes in pleural pressure were high and when blood volume was low. These results suggest that the driving pressure for blood flow during chest compression may be increased by lung inflation when the pulmonary blood vessels are filled with blood. However, blood may become trapped in the right heart and unavailable for transfer to the periphery during chest compression if lung inflation causes the alveolar blood vessels to collapse.
利用离体的、纤维颤动的犬心肺制备模型，我们研究了在心肺复苏模型中同时进行肺充气和胸外按压对血流的影响。心脏和肺被置于一个人工胸腔内，大血管和气管分别外置并连接到一个人工灌注回路和呼吸机上。调节系统的血容量以获得不同水平的静态平衡压力。通过周期性地升高和降低人工胸腔内的压力来模拟心肺复苏过程中胸膜压力的变化，从而获得血流情况。当胸膜压力变化较小时且静态平衡压力较高时，按压阶段的肺充气会导致心肺复苏血流增加。相反，当胸膜压力变化较大且血容量较低时，肺充气会导致血流减少。这些结果表明，当肺血管充满血液时，肺充气可能会增加胸外按压期间血流的驱动压力。然而，如果肺充气导致肺泡血管塌陷，血液可能会被困在右心，在胸外按压期间无法输送到外周。
