Preterminal gasping and effects on the cardiac function.
Preterminal gasping and effects on the cardiac function.
复制标题
临终喘息及其对心脏功能的影响。
DOI：
10.1097/01.ccm.0000246010.88375.e4
复制
发表时间：
2006
影响因子：
8.8
通讯作者：
Hickey,RobertW
中科院分区：
文献类型：
--
作者：
Manole,MioaraD;Hickey,RobertW
目的：喘息，又称无意义呼吸，是哺乳动物缺氧或缺血后出现的终末模式，是一种普遍存在的现象。本文综述了喘息的生理学、在心脏骤停时喘息的发生率和意义，以及喘息对心脏功能的影响。设计：查阅有关喘息与心脏功能的相关人和动物文献。结果：喘息起源于中枢神经系统的延髓区域。喘息在心脏骤停时很常见：它发生在所有动物的室颤期间，大多数(31/32)患有婴儿猝死综合征的婴儿，以及30-40%的成人心脏骤停事件。动物研究表明，喘气与吸气期胸腔内压降低有关，吸气相促进静脉回流，呼气期胸腔内压升高，有利于冠脉血流。结论：喘息对幼年哺乳类动物具有自主复苏作用，可改善成年哺乳类动物心肺复苏的效果。喘息与重要的心肺变化有关：肺气体交换改善，静脉回流心脏增加，心输出量、心脏收缩能力、主动脉压和冠脉灌注压增加。
Objective:Gasping, also known as agonal respirations, is the terminal pattern that occurs after anoxia or ischemia and is a universal phenomenon in mammals. In this article we review the physiology of gasping, the prevalence and significance of gasping in cardiac arrest, and the effects of gasping on cardiac function.Design:Review relevant human and animal literature on gasping and cardiac function during gasping.Results:Gasping originates in the medullary area of the central nervous system. Gasping is prevalent during cardiac arrest: it occurs in all animals during ventricular fibrillation, in a majority of infants (31 of 32) with sudden infant death syndrome, and in 30–40% of witnessed episodes of cardiac arrest in adults. Animal studies demonstrated that gasping is associated with a decrease in intrathoracic pressure during the inspiratory phase, which promotes venous return and an increase in intrathoracic pressure during the expiratory phase, which favors coronary perfusion. Gasping increases cardiac output and cardiac contractility in immature animals exposed to anoxia.Conclusions:Gasping is auto-resuscitative in immature mammals and improves the outcome of cardiopulmonary resuscitation in mature mammals. Gasping is associated with important cardiorespiratory changes: improved pulmonary gas exchange, increased venous return to the heart, increased cardiac output, cardiac contractility, aortic pressure, and coronary perfusion pressure.