Schmitz B, Fischer M, Bockhorst K, Hoehn-Berlage M, Hossmann K A
Department of Experimental Neurology, Max-Planck-Institute for Neurological Research, Cologne, Germany.
Resuscitation. 1995 Dec;30(3):251-62. doi: 10.1016/0300-9572(95)00891-8.
The quality of brain recovery after cardiac arrest depends crucially on the speed of cardiac resuscitation because the low cerebral perfusion pressure during the resuscitation procedure facilitates the development of no-reflow. To accelerate return of spontaneous circulation, high dose epinephrine has been recommended but the effect on the dynamics of early brain recovery is still unknown. We, therefore, studied the dynamics of brain resuscitation after cardiopulmonary resuscitation (CPR) with standard and high dose epinephrine using non-invasive NMR techniques. Fifteen min cardiac arrest was induced in normothermic cats by ventricular fibrillation. CPR was performed using an inflatable pneumatic vest for cyclic chest compression. With the beginning of CPR the standard dose group received 0.02 mg/kg epinephrine (n = 6) and the high dose group received 0.2 mg/kg (n = 8). Brain recovery was monitored by magnetic resonance imaging of the apparent diffusion coefficient (ADC) of water for 3 h. Although high dose epinephrine treatment led to a significantly higher blood pressure during early reperfusion, rapidly changing heterogeneities of early brain recovery were observed in both groups. High dose epinephrine thus does not improve the quality of post-cardiac arrest brain recovery during the first 3 h of reperfusion.
心脏骤停后脑复苏的质量关键取决于心脏复苏的速度，因为复苏过程中脑灌注压低会促使无复流现象的发生。为加速自主循环恢复，已推荐使用高剂量肾上腺素，但对早期脑复苏动态变化的影响仍不清楚。因此，我们使用无创核磁共振技术研究了标准剂量和高剂量肾上腺素心肺复苏（CPR）后脑复苏的动态变化。通过室颤在体温正常的猫身上诱发15分钟心脏骤停。使用可充气气动背心进行循环胸外按压来实施CPR。CPR开始时，标准剂量组接受0.02mg/kg肾上腺素（n = 6），高剂量组接受0.2mg/kg（n = 8）。通过磁共振成像监测水的表观扩散系数（ADC）3小时以观察脑复苏情况。尽管高剂量肾上腺素治疗在早期再灌注期间导致血压显著升高，但两组均观察到早期脑复苏快速变化的异质性。因此，在再灌注的前3小时内，高剂量肾上腺素并不能改善心脏骤停后脑复苏的质量。
