Brown C G, Griffith R F, Neely D, Hobson J, Miller B
Department of Emergency Medicine, Ohio State University, Columbus 43210.
Resuscitation. 1993 Aug;26(1):3-12. doi: 10.1016/0300-9572(93)90157-l.
To determine the effect of magnesium administration on aortic, right atrial and coronary perfusion pressure (CPP) during cardiopulmonary resuscitation (CPR).
Twelve swine weighing 23.2 +/- 3.1 kg were instrumented for CPP, aortic systolic (AOSP) and aortic diastolic (AODP) pressures.
Ventricular fibrillation was induced and after 20 min of CPR the animals were allocated to receive epinephrine 0.2 mg/kg, or epinephrine 0.2 mg/kg plus magnesium 0.14 g/kg. Epinephrine was repeated every 5 min. Arterial blood gases were determined during normal sinus rhythm and prior to drug administration.
Pressures were recorded and averaged over four consecutive 5-min intervals following initial drug administration. AOSP, AODP and CPP were compared using an analysis of covariance. AOSP was statistically lower in the group receiving magnesium. There was a trend toward lower AODP and CPP in the group receiving magnesium as well. These statistical differences and trends were absent after adjusting for pressures during normal sinus rhythm and serum bicarbonate prior to drug administration.
In this model of prolonged cardiac arrest, the administration of magnesium with epinephrine appeared to have a negative effect on aortic pressures during CPR. Further study is needed to determine the confounding effect of serum bicarbonate on the response to epinephrine and magnesium during CPR.
确定在心肺复苏（CPR）期间给予镁对主动脉、右心房及冠状动脉灌注压（CPP）的影响。
对12头体重为23.2±3.1千克的猪进行仪器植入以测量CPP、主动脉收缩压（AOSP）和主动脉舒张压（AODP）。
诱发心室颤动，在CPR 20分钟后，将动物分为两组，一组接受0.2毫克/千克肾上腺素，另一组接受0.2毫克/千克肾上腺素加0.14克/千克镁。每5分钟重复给予肾上腺素。在正常窦性心律期间及给药前测定动脉血气。
在首次给药后的四个连续5分钟间隔内记录压力并求平均值。使用协方差分析比较AOSP、AODP和CPP。接受镁的组中AOSP在统计学上较低。接受镁的组中AODP和CPP也有降低的趋势。在根据正常窦性心律期间的压力及给药前血清碳酸氢盐进行校正后，这些统计学差异和趋势消失。
在这个长时间心脏骤停模型中，CPR期间肾上腺素与镁联合使用似乎对主动脉压力有负面影响。需要进一步研究以确定血清碳酸氢盐对CPR期间肾上腺素和镁反应的混杂效应。
