Winkler M, Mauritz W, Hackl W, Gilly H, Weindlmayr-Goettel M, Steinbereithner K, Schindler I
Ludwig Boltzmann Institute of Experimental Anaesthesia and Research in Intensive Care Medicine, Vienna, Austria.
Eur J Emerg Med. 1998 Jun;5(2):201-6.
The effects of half the tidal volume during cardiopulmonary resuscitation (CPR) on haemodynamics, acid-base balance, and oxygenation were studied in anaesthetized pigs. The animals were ventilated with a mean tidal volume of 12.5 +/- 0.5 ml/kg at a rate of 14/minute resulting in a mean arterial pCO2 of 40 +/- 3 mmHg. They were randomly assigned to two groups: in one group ventilation was performed with half the pre-arrest tidal volume (50% group; n = 9), in the other group ventilation remained unchanged during CPR (100% group; n = 10). After 8 minutes of CPR attempts were made to restore spontaneous circulation with epinephrine and countershocks. There were no differences in advanced life support requirements, haemodynamic parameters, and resuscitability between the two groups. During CPR up to 5 minutes after restoration of spontaneous circulation (ROSC) dead space ventilation was significantly higher in the 50% group compared with the 100% group (p < 0.05). During CPR (at 3 and 7 minutes) arterial pO2 values were significantly lower (218 +/- 136 and 221 +/- 120 mmHg vs. 381 +/- 130 and 352 +/- 147 mmHg; FiO2 1.0) and hyperventilation was less pronounced (34.4 +/- 7.3 and 31.3 +/- 7.7 mmHg vs. 26.2 +/- 5.6 and 26.9 +/- 6.3 mmHg) in the 50% group. Our results suggest that half the tidal volume during CPR is likely to establish a more physiological acid-base balance and has no adverse effects on haemodynamics in intubated pigs ventilated with pure oxygen.
在麻醉猪身上研究了心肺复苏（CPR）期间潮气量减半对血流动力学、酸碱平衡和氧合的影响。动物以平均潮气量12.5±0.5 ml/kg、频率14次/分钟进行通气，导致平均动脉血二氧化碳分压为40±3 mmHg。它们被随机分为两组：一组在CPR期间以骤停前潮气量的一半进行通气（50%组；n = 9），另一组在CPR期间通气保持不变（100%组；n = 10）。CPR 8分钟后，尝试用肾上腺素和电击恢复自主循环。两组在高级生命支持需求、血流动力学参数和复苏能力方面没有差异。在CPR期间，直至自主循环恢复（ROSC）后5分钟，50%组的死腔通气明显高于100%组（p < 0.05）。在CPR期间（3分钟和7分钟时），50%组的动脉血氧分压值明显较低（218±136和221±120 mmHg，而381±130和352±147 mmHg；吸入氧分数1.0），过度通气不那么明显（34.4±7.3和31.3±7.7 mmHg，而26.2±5.6和26.9±6.3 mmHg）。我们的结果表明，CPR期间潮气量减半可能会建立更生理的酸碱平衡，并且对用纯氧通气的插管猪的血流动力学没有不利影响。
