Kern K B, Carter A B, Showen R L, Voorhees W D, Babbs C F, Tacker W A, Ewy G A
J Am Coll Cardiol. 1986 Apr;7(4):859-67. doi: 10.1016/s0735-1097(86)80348-5.
Two new modifications of manual cardiopulmonary resuscitation, high impulse compression at a rate of 120/min and interposed abdominal compression at a rate of 60/min, have been reported to produce better hemodynamic responses than standard cardiopulmonary resuscitation at 60/min. However, the effect of these two new methods on initial resuscitation success and 24 hour survival is unknown. In this study, 30 mongrel dogs were divided into three equal groups, each treated with one of three types of manual cardiopulmonary resuscitation. Ventricular fibrillation was induced electrically in morphinized, endotracheally intubated dogs emerging from halothane anesthesia. After 3 minutes of circulatory arrest without intervention, one of the three techniques of manual cardiopulmonary resuscitation was begun, and continued for 17 minutes. Defibrillation was performed at 20 minutes. Successful resuscitation was defined as a mean arterial blood pressure of at least 60 mm Hg, without chest compressions, 10 minutes after the initial defibrillation attempt. Intensive care was provided for 2 hours, including hemodynamic and respiratory monitoring, and drug intervention when required. Twenty-four hour survival and neurologic deficit were used as critical measures of outcome. Ten of 30 animals survived 24 hours with a mean neurologic deficit score of 5% (normal = 0, brain dead = 100). There was no difference in initial resuscitation success, 24 hour survival or neurologic deficit of the survivors among the three manual cardiopulmonary resuscitation methods. Aortic diastolic and calculated coronary perfusion pressures were similar for all three methods. Well performed standard manual cardiopulmonary resuscitation is as effective as these modified versions (high impulse compression and interposed abdominal compression) when compared in the same animal model.
据报道，两种新的徒手心肺复苏术改良方法，即每分钟120次的高冲击按压和每分钟60次的腹部按压，比每分钟60次的标准心肺复苏术能产生更好的血流动力学反应。然而，这两种新方法对初始复苏成功率和24小时生存率的影响尚不清楚。在本研究中，30只杂种狗被平均分为三组，每组接受三种徒手心肺复苏术方法中的一种治疗。在从氟烷麻醉中苏醒的、经吗啡处理且气管插管的狗身上，通过电刺激诱发心室颤动。在未进行干预的循环骤停3分钟后，开始三种徒手心肺复苏术技术中的一种，并持续17分钟。在20分钟时进行除颤。成功复苏的定义为首次除颤尝试后10分钟，在不进行胸外按压的情况下平均动脉血压至少为60毫米汞柱。提供2小时的重症监护，包括血流动力学和呼吸监测，并在需要时进行药物干预。24小时生存率和神经功能缺损被用作关键的结局指标。30只动物中有10只存活24小时，平均神经功能缺损评分为5%（正常=0，脑死亡=100）。三种徒手心肺复苏术方法在初始复苏成功率、24小时生存率或存活者的神经功能缺损方面没有差异。三种方法的主动脉舒张压和计算得出的冠状动脉灌注压相似。在同一动物模型中进行比较时，操作良好的标准徒手心肺复苏术与这些改良版本（高冲击按压和腹部按压）同样有效。
