Bartlett R L, Stewart N J, Raymond J, Anstadt G L, Martin S D
Ann Emerg Med. 1984 Sep;13(9 Pt 2):773-7. doi: 10.1016/s0196-0644(84)80433-3.
Presented are the results of a comparison study of three forms of circulatory support during ventricular fibrillation: closed-chest compression (CCC), open-chest manual compression (OCMC), and direct mechanical ventricular assistance (DMVA). DMVA is a method of circulatory support using a bell-shaped device that is affixed to the heart by apical suction and that alternately compresses and expands the ventricles. CCC produced a cardiac index (CI) of 780 mL/min/m2 (19% of control) with a mean arterial pressure (MAP) of 26 mm Hg (23% of control). Both forms of direct cardiac compression produced higher values. OCMC at 60 compressions per minute (CPM) produced a CI of 2,069 mL/min/m2 (52% of control) with an MAP of 50 mm Hg (45% of control). DMVA at the same rate produced a CI of 2,780 mL/min/m2 (70% of control) with an MAP of 72 mm Hg (65% of control). The values for DMVA at 60 CPM were significantly higher than for OCMC at 60 CPM (P less than .005 for CI, and P less than .0005 for MAP). Changing from standard CCC to DMVA at 90 CPM produced the greatest hemodynamic improvements: MAP increased by 250%, and CI increased by 340%. With DMVA at 90 CPM, the systolic pressure, stroke index, and CI were not statistically different from control, prearrest values.
闭胸按压（CCC）、开胸手动按压（OCMC）和直接机械心室辅助（DMVA）。DMVA是一种循环支持方法，使用一种钟形装置，通过心尖吸引固定在心脏上，交替压缩和扩张心室。CCC产生的心指数（CI）为780 mL/min/m²（为对照值的19%），平均动脉压（MAP）为26 mmHg（为对照值的23%）。两种直接心脏按压形式产生的值更高。每分钟60次按压（CPM）的OCMC产生的CI为2069 mL/min/m²（为对照值的52%），MAP为50 mmHg（为对照值的45%）。相同速率下的DMVA产生的CI为2780 mL/min/m²（为对照值的70%），MAP为72 mmHg（为对照值的65%）。每分钟60次按压时DMVA的值显著高于每分钟60次按压时的OCMC（CI的P值小于0.005，MAP的P值小于0.0005）。从标准CCC改为每分钟90次按压的DMVA产生了最大的血流动力学改善：MAP增加了250%，CI增加了340%。在每分钟90次按压时使用DMVA，收缩压、每搏指数和CI与对照值、心脏骤停前值在统计学上无差异。
