Controlled sequential elevation of the head and thorax combined with active compression decompression cardiopulmonary resuscitation and an impedance threshold device improves neurological survival in a porcine model of cardiac arrest.
Controlled sequential elevation of the head and thorax combined with active compression decompression cardiopulmonary resuscitation and an impedance threshold device improves neurological survival in a porcine model of cardiac arrest.
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头部和胸部的受控顺序抬高结合主动加压减压心肺复苏和阻抗阈值装置可改善心脏骤停猪模型的神经存活率。
DOI：
10.1016/j.resuscitation.2020.09.030
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发表时间：
2021-01
期刊：
影响因子：
6.5
通讯作者：
G Lurie K
中科院分区：
文献类型：
--
作者：
Moore JC;Salverda B;Rojas-Salvador C;Lick M;Debaty G;G Lurie K
在先前的动物研究中，与传统的仰卧位相比，在使用阻抗阈值装置（ITD）的主动加压减压（ACD）心肺复苏（CPR）过程中，头和胸部（CSE）的受控顺序抬高已被证明可增加脑灌注压和脑血流量。这种新的捆绑治疗策略在改善神经功能完整的生存率方面的潜力尚不清楚。对雌性农场猪进行镇静、插管和麻醉。连续监测中心动脉和静脉通路。还经皮测量了局部脑组织灌注（CerO 2）。诱发室颤（VF）并未经治疗10分钟。将猪随机分配至1）常规CPR（C-CPR）平面或2）ACD+ITD CSE CPR，包括2分钟ACD+ITD，头部和心脏首先升高10 cm和8 cm，然后在2分钟内逐渐升高，分别升高至22 cm和9 cm。心肺复苏19分钟后，对猪进行除颤并恢复。对干预设盲的兽医在24小时评估了脑功能分类（CPC）。神经功能完好的结局定义为CPC评分为1或2。分类结果采用Fisher精确检验进行分析，连续结果采用非配对学生t检验进行分析。在16只动物中，ACD+ITD CSE组的自主循环恢复率为8/8（100%），C-CPR组为3/8（25%）（p = 0.026）。对于神经系统完整生存期的主要结局，ACD+ITD CSE组6/8（75%）头猪的CPC评分为1或2，C-CPR组1/8（12.5%）头猪的CPC评分为1或2（p = 0.04）。CSE组18分钟时的冠状动脉灌注压（mmHg，平均值± SD）较高（41 ± 24 vs 10 ± 5，p = 0.004）。CSE组18分钟时rSO 2（%，平均值± SD）和ETCO 2（mmHg，平均值± SD）值分别较高（32 ± 9 vs 17 ± 2，p = 0.01和55 mmHg ± 10 vs 21 mmHg ± 4，p < 0.001）。在猪心脏骤停模型中，与C-CPR相比，CSE + ACD+ITD CPR的新型捆绑复苏方法增加了有利的神经存活率。
Controlled sequential elevation of the head and thorax (CSE) during active compression decompression (ACD) cardiopulmonary resuscitation (CPR) with an impedance threshold device (ITD) has been shown to increase cerebral perfusion pressure and cerebral blood flow in previous animal studies as compared to the traditional supine position. The potential for this novel bundled treatment strategy to improve survival with intact neurological function is unknown. Female farm pigs were sedated, intubated, and anesthetized. Central arterial and venous access were continuously monitored. Regional brain tissue perfusion (CerO2) was also measured transcutaneous. Ventricular fibrillation (VF) was induced and untreated for 10 minutes. Pigs were randomized to 1) Conventional CPR (C-CPR) flat or 2) ACD+ITD CSE CPR that included 2 min of ACD+ITD with the head and heart first elevated 10 and 8 cm, and then gradual elevation over 2 min to 22 and 9 cm, respectively. After 19 min of CPR, pigs were defibrillated and recovered. A veterinarian blinded to the intervention assessed cerebral performance category (CPC) at 24 hours. A neurologically intact outcome was defined as a CPC score of 1 or 2. Categorical outcomes were analyzed by Fisher’s exact test and continuous outcomes with an unpaired student’s t-test. In 16 animals, return of spontaneous circulation rate was 8/8 (100%) with ACD+ITD CSE and 3/8 (25%) for C-CPR (p = 0.026). For the primary outcome of neurologically intact survival, 6/8 (75%) pigs had a CPC score 1 or 2 with ACD+ITD CSE versus 1/8 (12.5%) with C-CPR (p = 0.04). Coronary perfusion pressure (mmHg, mean ± SD) was higher with CSE at 18 minutes (41 ± 24 vs 10 ± 5, p = 0.004). rSO2 (%, mean ± SD) and ETCO2 (mmHg, mean ± SD) values were higher at 18 minutes with CSE (32 ± 9 vs 17 ± 2, p = 0.01, and 55 mmHg ± 10 vs 21 mmHg ± 4, p < 0.001), respectively. The novel bundled resuscitation approach of CSE with ACD+ITD CPR increased favorable neurological survival versus C-CPR in a swine model of cardiac arrest.
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DOI：
10.1186/s13049-015-0164-5
发表时间：
2015-10-28
期刊：
Scandinavian journal of trauma, resuscitation and emergency medicine
影响因子：
--
作者：
Kwon Y;Debaty G;Puertas L;Metzger A;Rees J;McKnite S;Yannopoulos D;Lurie K
通讯作者：
Lurie K
影响因子：
6.5
作者：
Plaisance, P;Lurie, KG;Payen, D
通讯作者：
Payen, D
影响因子：
6.5
作者：
Ryu, Hyun Ho;Moore, Johanna C.;Lurie, Keith G.
通讯作者：
Lurie, Keith G.
影响因子：
37.8
作者：
SHULTZ, JJ;COFFEEN, P;LURIE, KG
通讯作者：
LURIE, KG
影响因子：
6.5
作者：
Debaty, Guillaume;Shin, Sang Do;Lurie, Keith
通讯作者：
Lurie, Keith