Donovan P J, Propp D A
J Emerg Med. 1985;3(2):105-16. doi: 10.1016/0736-4679(85)90041-1.
Calcium ions play a critical role in excitation-contraction coupling in the myocardial cell, leading to enhanced automaticity and contractility. For these reasons the American Heart Association and the National Academy of Science-National Research Council has advocated its use in cardiac arrest due to asystole and electromechanical dissociation (EMD). However, increasing evidence suggests that calcium has been of little benefit in cardiac arrest not only because of the poor salvage rates (0%-8%) of victims in asystole or EMD and the dangerously high serum calcium levels following standard calcium administration, but also because of the cellular accumulation of calcium within the myocardium that occurs during cardiac arrest. In fact, some authors advocate the use of calcium channel blockers in protecting myocardial tissue during anoxia. Therefore the usefulness of calcium in asystole and EMD is highly suspect and must be reevaluated.
钙离子在心肌细胞的兴奋 - 收缩偶联中起关键作用，导致自律性和收缩性增强。基于这些原因，美国心脏协会和美国国家科学院 - 国家研究委员会主张在心脏停搏（由于心搏停止和电机械分离）时使用钙离子。然而，越来越多的证据表明，钙离子对心脏停搏几乎没有益处，这不仅是因为心搏停止或电机械分离患者的抢救成功率很低（0% - 8%），而且在标准补钙后血清钙水平会危险地升高，还因为心脏停搏期间心肌细胞内会出现钙蓄积。事实上，一些作者主张使用钙通道阻滞剂在缺氧期间保护心肌组织。因此，钙离子在心搏停止和电机械分离中的效用非常值得怀疑，必须重新评估。
