Kern K B, Hilwig R, Ewy G A
Department of Medicine, University of Arizona, Tucson.
Am Heart J. 1994 Sep;128(3):490-9. doi: 10.1016/0002-8703(94)90622-x.
Cardiopulmonary resuscitation-generated coronary perfusion pressure and intracoronary flow velocity was studied with high-fidelity pressure transducers and an intracoronary Doppler catheter in 11 swine undergoing closed-chest manual cardiopulmonary resuscitation. Retrograde coronary blood flow in the mid left anterior descending coronary artery was documented during the compression (systolic) phase of chest compression. Techniques to enhance coronary perfusion pressure gradients, such as increasing the chest compression rate or increasing the force of compression, did not improve antegrade coronary blood flow velocity. Even when the aortic minus right atrial pressure gradient was raised throughout the cardiac cycle of closed-chest manual cardiopulmonary resuscitation, antegrade coronary flow occurred only during the relaxation phase of chest compressions. This study indicates that coronary blood flow during ventricular fibrillation and closed-chest cardiopulmonary resuscitation occurs only during diastole or the release phase of chest compression and supports the use of diastolic coronary perfusion pressure as a reflection of myocardial blood flow during closed-chest manual cardiopulmonary resuscitation.
使用高保真压力传感器和冠状动脉内多普勒导管，对11只接受闭胸徒手心肺复苏的猪进行了心肺复苏产生的冠状动脉灌注压和冠状动脉内血流速度的研究。在胸部按压的压缩（收缩）阶段记录了左前降支冠状动脉中段的逆行冠状动脉血流。提高冠状动脉灌注压梯度的技术，如增加胸部按压频率或增加按压力度，并未改善冠状动脉顺行血流速度。即使在闭胸徒手心肺复苏的整个心动周期中主动脉减去右心房压力梯度升高时，冠状动脉顺行血流也仅在胸部按压的舒张期出现。本研究表明，心室颤动和闭胸心肺复苏期间的冠状动脉血流仅在舒张期或胸部按压的放松阶段出现，并支持使用舒张期冠状动脉灌注压来反映闭胸徒手心肺复苏期间的心肌血流。
