Xu X, Ogata H
First Department of Anesthesiology School of Medicine, Dokkyo University, Tochigi, Japan.
Crit Care Med. 1994 Dec;22(12):1987-94.
To observe the influence of prolonged cardiac arrest times on neurologic outcome and heart resuscitability, using a resuscitation model with cardiopulmonary bypass in the rabbit, and to determine whether the changes in the plasma concentrations of lactate and lipoperoxide correlate with the severity of global brain ischemia.
Randomized, prospective, controlled animal trial.
University research laboratory.
Forty-three New Zealand white rabbits.
Rabbits were randomly assigned to one of five groups: control, and four groups with cardiac arrest times of 8, 10, 12, and 15 mins. A bolus of 4 to 6 mL of 0.5-M potassium chloride was injected into the right atrium to induce cardiac arrest within 5 secs. Resuscitation was performed using closed-chest cardiopulmonary bypass, and mechanical ventilation with pure oxygen. When necessary, a DC shock of 10 joules/kg was used to terminate ventricular fibrillation.
Hemodynamics, electroencephalogram, electrocardiogram, and return times of various cranial reflexes were observed throughout the experiment. Plasma concentrations of lactate and lipoperoxide were determined before cardiac arrest and 5, 30, 90, and 150 mins after resuscitation. The neurologic outcome, measured by Neurologic Deficit Score, was determined at 150 mins postresuscitation. Values for the Neurologic Deficit Score were: 8 +/- 8 in the control group; 31 +/- 13; 37 +/- 19; 69 +/- 22; and 62 +/- 26 in the cardiac arrest groups of 8, 10, 12, and 15 mins, respectively. No significant differences in cardiac resuscitability were found among the four cardiac arrest groups. The plasma concentrations of lactate and lipoperoxide were significantly higher than the prearrest levels; however, there were no significant differences among the four cardiac arrest groups.
Cardiopulmonary bypass can be used to establish a resuscitation model in rabbits. Neurologic outcome worsens progressively in proportion to the prolonged cardiac times, especially when it exceeds 10 mins. Cardiac resuscitability is still possible, even when arrest time exceeds 15 mins. Changes in plasma concentrations of lactate and lipoperoxide do not correlate with the neurologic outcome and heart resuscitability following cardiac arrest.
使用兔体外循环复苏模型，观察延长心脏骤停时间对神经功能转归和心脏复苏能力的影响，并确定血浆乳酸和脂质过氧化物浓度的变化是否与全脑缺血的严重程度相关。
随机、前瞻性、对照动物试验。
大学研究实验室。
43只新西兰白兔。
将兔子随机分为五组：对照组，以及心脏骤停时间分别为8、10、12和15分钟的四组。向右心房注射4至6毫升0.5摩尔/升的氯化钾推注液，在5秒内诱导心脏骤停。使用闭胸体外循环和纯氧机械通气进行复苏。必要时，使用10焦耳/千克的直流电休克终止心室颤动。
在整个实验过程中观察血流动力学、脑电图、心电图和各种颅神经反射的恢复时间。在心脏骤停前以及复苏后5、30、90和150分钟测定血浆乳酸和脂质过氧化物浓度。在复苏后150分钟通过神经功能缺损评分来确定神经功能转归。神经功能缺损评分值分别为：对照组8±8；心脏骤停8、10、12和15分钟组分别为31±13、37±19、69±22和62±26。在四个心脏骤停组之间未发现心脏复苏能力有显著差异。血浆乳酸和脂质过氧化物浓度显著高于骤停前水平；然而，四个心脏骤停组之间没有显著差异。
体外循环可用于建立兔复苏模型。神经功能转归随着心脏骤停时间的延长而逐渐恶化，尤其是当超过10分钟时。即使心脏骤停时间超过15分钟，心脏仍有可能复苏。心脏骤停后血浆乳酸和脂质过氧化物浓度的变化与神经功能转归和心脏复苏能力无关。
