Optimizing standard cardiopulmonary resuscitation with an inspiratory impedance threshold valve
Optimizing standard cardiopulmonary resuscitation with an inspiratory impedance threshold valve
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DOI：
10.1378/chest.113.4.1084
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发表时间：
1998-04-01
期刊：
影响因子：
9.6
通讯作者：
Lindner, KH
中科院分区：
文献类型：
--
作者：
Lurie, KG;Mulligan, KA;Lindner, KH
目的：本研究旨在评估间歇性吸气气体交换阻抗是否能提高标准心肺复苏术（CPR）的效率。背景：标准CPR依赖于胸部的自然弹性回缩来暂时降低胸内压，从而促进静脉血回流至心脏。为了进一步提高负胸内压在“放松”阶段的CPR，我们测试的假设，间歇性阻抗吸气气体在标准CPR增加冠状动脉灌注压和重要器官perfusion.Methods：CPR进行了一个心脏起搏器驱动的自动化设备在猪模型的心室颤动。8头猪随机分配，最初仅接受标准CPR，而7头猪最初接受标准CPR加间歇阻抗吸气气体交换，阈值阀设置为-40 cm H2O。的压缩：通气比为5：1和压缩率为80/min。在7分钟的时间间隔，阻抗阈值阀（ITV）被添加或从通气回路中删除，这样，在28分钟的CPR，每只动物收到两个7分钟的CPR期间与ITV和两个7分钟的期间没有valve.Results：重要器官的血流量显着高于在CPR期间进行ITV比没有阀。左心室总血流量（平均值± SEM）（mL/min/g）为0.32 ± 0.04 vs 0.23 ± 0.03（无ITV）（p
Objectives: This study was designed to assess whether intermittent impedance of inspiratory gas exchange improves the efficiency of standard cardiopulmonary resuscitation (CPR).Background: Standard CPR relies on the natural elastic recoil of the chest to transiently decrease intrathoracic pressures and thereby promote venous blood return to the heart. To further enhance the negative intrathoracic pressures during the "relaxation" phase of CPR, we tested the hypothesis that intermittent impedance to inspiratory gases during standard CPR increases coronary perfusion pressures and vital organ perfusion.Methods: CPR was performed with a pneumatically driven automated device in a porcine model of ventricular fibrillation. Eight pigs were randomized to initially receive standard CPR alone, while seven pigs initially received standard CPR plus intermittent impedance to inspiratory gas exchange with a threshold valve set to -40 cm H2O. The compression:ventilation ratio was 5:1 and the compression rate was 80/min. At 7-min intervals the impedance threshold valve (ITV) was either added or removed from the ventilation circuit such that during the 28 min of CPR, each animal received two 7-min periods of CPR with the ITV and two 7-min periods without the valve.Results: Vital organ blood flow was significantly higher during CPR performed with the ITV than during CPR performed without the valve. Total left ventricular blood flow (mean+/-SEM) (mL/min/g) was 0.32+/-0.04 vs 0.23+/-0.03 without the ITV (p