Strohmenger H U, Lindner K H, Prengel A W, Pfenninger E G, Bothner U, Lurie K G
Department of Anesthesiology and Critical Care Medicine, University of Ulm, Germany.
Resuscitation. 1996 Feb;31(1):65-73. doi: 10.1016/0300-9572(95)00899-3.
This study was designed to assess whether median frequency of ventricular fibrillation (VF) correlates with myocardial blood flow and defibrillation success during cardiopulmonary resuscitation (CPR) after epinephrine or vasopressin administration.
After 4 min of VF and 3 min of CPR, 14 pigs received 0.045 mg/kg epinephrine or 0.4 U/kg vasopressin. Using radio-labeled microspheres, median myocardial blood flow during CPR before, and 90 s and 5 min after drug administration (DA) was 15.5 (12.6, 23.1; 25th percentile, 75th percentile), 26.4 (18.5, 29.1), 16.9 (14.9, 19.1) mL min-1 100 g-1, respectively, in the epinephrine, and 16.9 (15.4, 18.9), 48.1 (36.9, 68.9) (P < 0.05 vs. before DA), 52.3 (38.5, 65.0) mL min-1 100 g-1, respectively, in the vasopressin group. Using spectral analysis of VF, median frequency of VF was 11.0 (10.7, 11.8), 11.3 (9.6, 13.1), 10.2, (8.8, 11.4) Hz, respectively, in the epinephrine, and 10.1 (10.0, 10.5), 11.7 (11.1, 14.2) (P < 0.05 vs. before DA), 13.2 (11.5, 13.9) Hz, respectively, in the vasopressin group at the same points in time. Median frequency correlates significantly with myocardial blood flow in the epinephrine (n = 21); rs = 0.772; P < 0.001) and in the vasopressin group (n = 21; rs = 0.905; P < 0.001). Median fibrillation frequency before the first defibrillation was 13.0 (12.2, 13.2) Hz in resuscitated (n = 8) and 9.2 (8.3, 10.2) Hz (n = 6) in non-resuscitated animals (P < 0.01).
We conclude that median frequency of VF reflects myocardial blood flow and the chance of successful defibrillation during closed-chest CPR after vasopressor treatment in a porcine model of VF.
本研究旨在评估肾上腺素或血管加压素给药后心肺复苏（CPR）期间室颤（VF）的中位频率是否与心肌血流及除颤成功率相关。
在室颤4分钟和心肺复苏3分钟后，14头猪接受0.045mg/kg肾上腺素或0.4U/kg血管加压素。使用放射性标记微球，肾上腺素组在给药前、给药后90秒和5分钟时心肺复苏期间的中位心肌血流分别为15.5（12.6，23.1；第25百分位数，第75百分位数）、26.4（18.5，29.1）、1十六条点九（14.9，19.1）mL·min⁻¹·100g⁻¹，血管加压素组分别为16.9（15.4，18.9）、48.1（36.9，68.9）（与给药前相比P<0.05）、52.3（38.5，65.0）mL·min⁻¹·100g⁻¹。通过室颤频谱分析，肾上腺素组在相同时间点室颤的中位频率分别为11.0（10.7，11.8）、11.3（9.6，13.1）、10.2（8.8，11.4）Hz，血管加压素组分别为10.1（10.0，10.5）、11.7（11.1，14.2）（与给药前相比P<0.05）、13.2（11.5，13.9）Hz。在肾上腺素组（n=21）和血管加压素组（n=21）中，中位频率与心肌血流显著相关；rs分别为0.772（P<0.001）和0.905（P<0.001）。首次除颤前复苏成功的动物（n=8）室颤中位频率为13.0（12.2，13.2）Hz，未复苏成功的动物（n=6）为9.2（8.3，10.2）Hz（P<0.01）。
我们得出结论，在猪室颤模型中，血管升压药治疗后闭胸心肺复苏期间室颤的中位频率反映心肌血流及成功除颤的机会。
