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心脏骤停时酸碱状态的演变。

Evolution of the acid-base status in cardiac arrest.

作者信息

Carrasco H A, Oletta J F

出版信息

Calif Med. 1973 Jun;118(6):7-12.

Abstract

In a study of the evolution of acid-base status in 26 patients who had cardiopulmonary arrest in the operating room, it appeared that:The determination of acid-base status within the first hour post-cardiac arrest is useful in differentiating final survivors from non-survivors. Respiratory or combined acidosis carries a poor prognosis not evidenced for metabolic acidosis. Late respiratory complications are more frequent in patients with initial combined acidosis. Treatment should be instituted on the basis of frequent determinations of acidbase status, since accurate diagnosis of degree and type of acidosis cannot be done on clinical grounds only. Recovery of consciousness is influenced by the type and severity of acidosis, less so by duration of arrest; and that high pCO(2) is associated frequently with unconsciousness after recovery of circulatory function.

摘要

在一项对26例在手术室发生心肺骤停患者酸碱状态演变的研究中,发现:心脏骤停后1小时内酸碱状态的测定有助于区分最终存活者和非存活者。呼吸性或混合性酸中毒预后不良,代谢性酸中毒则无此表现。初始为混合性酸中毒的患者后期呼吸并发症更常见。应根据频繁测定的酸碱状态进行治疗,因为仅根据临床情况无法准确诊断酸中毒的程度和类型。意识的恢复受酸中毒类型和严重程度的影响,受骤停持续时间的影响较小;而且高pCO₂常常与循环功能恢复后意识不清有关。

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本文引用的文献

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Acid-base studies in experimental circulatory arrest.
Lancet. 1962 Nov 10;2(7263):967-9. doi: 10.1016/s0140-6736(62)90730-4.
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Acid-base studies after cardiac arrest. A report on 64 cases.心脏骤停后的酸碱研究。64例报告。
Acta Anaesthesiol Scand Suppl. 1966;23:235-41. doi: 10.1111/j.1399-6576.1966.tb01016.x.
6
Treatment of acidoisis and electrolyte disturbances in asphyzia and cardiac arrest.
Acta Anaesthesiol Scand Suppl. 1968;29:165-82. doi: 10.1111/j.1399-6576.1968.tb00732.x.
7
The acidosis of cardiac arrest.心脏骤停的酸中毒
N Engl J Med. 1968 Feb 15;278(7):360-4. doi: 10.1056/NEJM196802152780703.
8
A five year review of 734 cardiopulmonary arrests.734例心肺骤停的五年回顾
South Med J. 1970 May;63(5):506-10. doi: 10.1097/00007611-197005000-00006.
9
Serial blood gas studies during cardiopulmonary resuscitation.
Ann Intern Med. 1970 Apr;72(4):465-9. doi: 10.7326/0003-4819-72-4-465.
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Cardiac resuscitation in the operating room: current status.手术室中的心脏复苏:现状
Ann Surg. 1970 Jun;171(6):948-55. doi: 10.1097/00000658-197006010-00016.

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