Glucose administration before cardiac arrest worsens neurologic outcome in cats.
Glucose administration before cardiac arrest worsens neurologic outcome in cats.
复制标题
心脏骤停前给予葡萄糖会恶化猫的神经系统结果。
DOI：
10.1097/00000542-199006000-00010
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发表时间：
1990
期刊：
影响因子：
8.8
通讯作者：
Shapiro,HM
中科院分区：
文献类型：
--
作者：
Nakakimura,K;Fleischer,JE;Drummond,JC;Scheller,MS;Zornow,MH;Grafe,MR;Shapiro,HM
在20只猫中研究了葡萄糖对全脑缺血后神经和神经病理结果的影响，这些猫在心脏骤停14分钟后进行了闭胸复苏和重症监护。从心脏骤停前30分钟开始，以盲法在15分钟内给予15 ml/kg溶于0.45%生理盐水的5%葡萄糖或相同体积的0.9%生理盐水。电诱导室颤，并根据标准化方案进行心脏复苏，包括闭合胸部心脏按压、肾上腺素、利多卡因、碳酸氢钠给药，和电除颤。在4分钟内未复苏的动物从进一步研究中排除。复苏后24小时，在重症监护环境中管理复苏动物。在复苏后2、4和7天对神经功能缺损进行评分。随后，对动物的大脑进行组织学检查。从数据分析中排除了9只猫。3只不符合方案标准，6只无法在4分钟内复苏。由于技术错误，未对1只葡萄糖处理猫的大脑进行分析。六只盐水处理的动物和五只葡萄糖处理的动物符合所有方案标准，并在复苏后存活了7天。生理盐水组心脏停搏前的血糖浓度为118+/-24 mg/dl（平均值+/-SD），葡萄糖组为269+/-21 mg/dl（P <0.01）。葡萄糖处理猫在复苏后2、4和7天的神经功能结局等级显著更差（分别为P <0.01、P <0.01和P <0.01）。葡萄糖和生理盐水治疗组之间的神经病理学评分无差异（P= 0.07）。（250字处删节）
The effects of glucose on neurologic and neuropathologic outcome following global cerebral ischemia were examined in 20 cats subjected to 14 min of cardiac arrest, followed by closed chest resuscitation and intensive care monitoring. Beginning 30 min prior to cardiac arrest, 15 ml/kg of 5% dextrose in 0.45% saline or the same volume of 0.9% saline was administered in a blinded fashion over 15 min. Ventricular fibrillation was electrically induced and cardiac resuscitation was performed according to a standardized protocol, which included closed chest cardiac compressions, epinephrine, lidocaine, sodium bicarbonate administration, and electrical defibrillation. Animals not resuscitated within 4 min were excluded from further study. Resuscitated animals were managed in an intensive care setting for 24 h postresuscitation. Neurologic deficits were scored at 2, 4, and 7 days postresuscitation. Subsequently, the animals' brains underwent histologic examination. Nine cats were excluded from data analysis. Three did not meet protocol criteria and six could not be resuscitated within 4 min. As a result of a technical error, the brain of one glucose-treated cat was not analyzed. Six saline-treated and five glucose-treated animals met all protocol criteria and survived for 7 days postresuscitation. Plasma glucose concentration before cardiac arrest was 118+/-24 mg/dl (mean+/-SD) in the saline group and 269+/-21 mg/dl in the glucose group (P less than 0.01). Neurologic outcome rank at 2, 4, and 7 days postresuscitation was significantly worse in glucose-treated cats (P less than 0.01, P less than 0.01, and P less than 0.01, respectively). The neuropathologic score did not differ between glucose-and saline-treated groups (P= 0.07).(ABSTRACT TRUNCATED AT 250 WORDS)