Abstract 20: Peripheral Intravenous Analysis Detects Return of Spontaneous Circulation Without Interruption of Chest Compressions in a Rat Model of Cardiopulmonary Resuscitation
Abstract 20: Peripheral Intravenous Analysis Detects Return of Spontaneous Circulation Without Interruption of Chest Compressions in a Rat Model of Cardiopulmonary Resuscitation
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摘要 20：外周静脉分析检测大鼠心肺复苏模型中不中断胸外按压的自主循环恢复情况
DOI：
10.1161/circ.140.suppl_2.20
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发表时间：
2019
期刊：
影响因子：
37.8
通讯作者：
Eagle Susan S
中科院分区：
文献类型：
--
作者：
Balzer C;Baudenbacher Franz J;Hernandez A;Salzman Michele M;Riess Matthias L;Eagle Susan S
引言：较高的胸外按压分数（CCF）或提供胸外按压的时间百分比与心脏骤停（CA）后生存率的改善相关。心肺复苏（CPR）期间暂停胸部按压以触摸脉搏可以减少CCF。外周静脉分析（PIVA）是一种使用标准外周静脉（IV）管路波形确定心脏和容量状态的新方法。Wehypothesize，PIVA将证明自发循环（ROSC）的恢复，而不中断CPR.Methods：8 Zucker糖尿病肥胖（ZDF）大鼠（4瘦，4糖尿病）插管，通气，并插管与24 g IV在尾静脉和22 g IV在股动脉，每个连接到TruWave压力传感器。停止机械通气以达到CA。8分钟后，CPR开始，机械通气，静脉注射肾上腺素，并以每分钟200次的速度使用1.5 cm的胸部按压，直到平均动脉压（MAP）增加到120 mmHg/动脉线。在LabChart中记录并分析所有波形。使用外周静脉波形的傅立叶变换测量PIVA。数据为平均值± SD。统计学：非配对t检验（双尾），α = 05。结果：8只大鼠均达到CA和ROSC。CPR后1分钟内，CPR期间PIVA增加/减少70 ± 35倍，与ROSC存在时间相关性。在PIVA降低的8 ± 13秒内，潮气末CO2迅速升高。在所有大鼠中，ROSC发生在最大PIVA值的38 ± 9秒内。在复苏和ROSC过程中，外周静脉压下降了1.2 ± 0.9 mmHg，在p= 0.05时无显著差异。结论：在本初步研究中，PIVA检测ROSC而不中断CPR。使用PIVA可能不需要暂停CPR进行脉搏检查，并可能导致更高的CCF和生存率。未来的研究将集中在PIVA和CPR的有效性。
Introduction:A higher chest compression fraction (CCF) or percentage of time providing chest compressions is associated with improved survival after cardiac arrest (CA). Pauses in chest compression duration during cardiopulmonary resuscitation (CPR) to palpate a pulse can reduce the CCF. Peripheral Intravenous Analysis (PIVA) is a novel method for determining cardiac and volume status using waveforms from a standard peripheral intravenous (IV) line. Wehypothesizethat PIVA will demonstrate the onset of return of spontaneous circulation (ROSC) without interruption of CPR.Methods:Eight Zucker Diabetic Fatty (ZDF) rats (4 lean, 4 diabetic) were intubated, ventilated, and cannulated with a 24g IV in the tail vein and a 22g IV in the femoral artery, each connected to a TruWave pressure transducer. Mechanical ventilation was discontinued to achieve CA. After 8 minutes, CPR began with mechanical ventilation, IV epinephrine, and chest compressions using 1.5 cm at 200 times per minute until mean arterial pressure (MAP) increased to 120 mmHg per arterial line. All waveforms were recorded and analyzed in LabChart. PIVA was measured using a Fourier transform of the peripheral venous waveform. Data are mean ± SD. Statistics: Unpaired student’s t-test (two-tailed), α = 05.Results:CA and ROSC were achieved in all 8 rats. Within 1 minute of CPR, there was a 70 ± 35 fold increase/decrease in PIVA during CPR that was temporally associated with ROSC. Within 8 ± 13 seconds of a reduction in PIVA, there was a rapid increase in end-tidal CO2. In all rats, ROSC occurred within 38 ± 9 seconds of the maximum PIVA value. Peripheral venous pressure decreased by 1.2 ± 0.9 mmHg during resuscitation and ROSC, which was not significant different at p=0.05.Conclusion:In this pilot study, PIVA detected ROSC without interrupting CPR. Use of PIVA may obviate the need pause CPR for pulse checks, and may result in a higher CCF and survival. Future studies will focus on PIVA and CPR efficacy.