Spontaneous gasping during cardiopulmonary resuscitation without mechanical ventilation.
Spontaneous gasping during cardiopulmonary resuscitation without mechanical ventilation.
复制标题
无机械通气的心肺复苏期间的自发喘息。
DOI：
10.1164/ajrccm.150.3.8087362
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发表时间：
1994
影响因子：
24.7
通讯作者：
Bisera,J
中科院分区：
文献类型：
--
作者：
Noc,M;Weil,MH;Sun,S;Tang,W;Bisera,J
在心脏骤停期间经常观察到自发喘息，特别是在心前压迫期间停止机械通气时。我们在一个啮齿类动物心脏骤停模型中，将自发喘气与肺气体交换和心脏复苏联系起来。电致15只Sprague-Dawley大鼠心室颤动。未经治疗的心室颤动4分钟后，开始心前压迫。冠脉灌注压维持在25 ~ 30 mm Hg之间。10只动物在开始心前压迫的同时在气管管口供氧。另外5只对照动物除了在开始心前压迫时进行机械通气外，其余均进行相同处理。在心前压迫6分钟后，尝试除颤，10只非通气动物中有5只和所有对照动物均通过直流反电击复苏。在成功复苏的非通气动物中，心前压迫期间自发喘息的频率逐渐增加到平均19次/分钟，而在未复苏的动物中，自发喘息的频率< 6次/分钟。更频繁的喘息与相应的动脉血PO2升高（110对51 mm Hg， p < 0.01）和PCO2降低（55对91 mm Hg， p < 0.01）相关。在对照动物中，在心前压迫期间未观察到自发喘气。机械通气大鼠动脉血PO2和PCO2与自发呼吸大鼠比较接近。因此，在没有机械通气的情况下，自发喘息的频率可以预测心脏复苏的成功，并与动脉氧合和二氧化碳去除的改善有关。
Spontaneous gasping is frequently observed during cardiac arrest, especially when mechanical ventilation is withheld during precordial compression. We related spontaneous gasping to pulmonary gas exchange and cardiac resuscitability in a rodent model of cardiac arrest. Ventricular fibrillation was electrically induced in 15 Sprague-Dawley rats. After 4 min untreated ventricular fibrillation, precordial compression was initiated. Coronary perfusion pressure was maintained between 25 and 30 mm Hg. Oxygen was supplied at the tracheal tube port coincident with start of precordial compression in 10 animals. Five additional control animals were identically treated except they were mechanically ventilated coincident with start of precordial compression. After 6 min precordial compression, defibrillation was attempted and five of 10 nonventilated animals, and all control animals, were resuscitated by direct current countershock. In the successfully resuscitated, nonventilated animals, the frequency of spontaneous gasping during precordial compression progressively increased to an average of 19 gasps/min but it was < 6 gasps/min in nonresuscitated animals. More frequent gasping was associated with correspondingly greater arterial PO2 (110 versus 51 mm Hg, p < 0.01) and lesser PCO2 (55 versus 91 mm Hg, p < 0.01). In control animals, no spontaneous gasping was observed during precordial compression. Arterial PO2 and PCO2 of mechanically ventilated animals was more like that of spontaneously gasping rats. According, the frequency of spontaneous gasping in absence of mechanical ventilation is predictive of cardiac resuscitation success and associated with improved arterial oxygenation and CO2 removal.