Cardiopulmonary Resuscitation and Direct Cardiac Injury: Evidence of Fractured Coronary Arteries and HIS Bundle Hemorrhage.
Cardiopulmonary Resuscitation and Direct Cardiac Injury: Evidence of Fractured Coronary Arteries and HIS Bundle Hemorrhage.
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心肺复苏和直接心脏损伤：冠状动脉骨折和 HIS 束流出血的证据。
DOI：
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发表时间：
1997
期刊：
影响因子：
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通讯作者：
Rose
中科院分区：
文献类型：
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作者：
Frink;Rose
据信，在实施闭胸心肺复苏术（CPR）期间，心脏可避免严重的直接损伤。然而，还没有对冠状动脉或房室传导系统进行全面的组织学研究，以确定这些结构是否可能被心肺复苏术损伤。这份报告包括一个回顾性的审查105人的心脏进行了广泛的研究，在尸检后注射彩色钡明胶质量到冠状动脉。研究组，83名男性和22名女性，包括63名（60%）在医院死亡的患者。80名患者（76%）在死亡前接受了CPR。在35例（44%）接受CPR的患者中发现了与冠状动脉和/或希氏束直接钝性损伤一致的证据。这些结构变化的特征是冠状动脉壁断裂和破裂和/或出血进入分支希氏束区域。女性年龄明显较大，这些病变的发生频率明显高于男性。损伤与CPR的实施部位、院内或院外无关，也与CPR的持续时间无关。我们的结论是，心肺复苏术与直接钝性损伤的证据冠状动脉和/或希氏束和近端束支，这些病变可能会影响复苏的努力，以及最终的预后的结果。
The heart is believed to escape serious direct injury during the administration of closed chest cardiopulmonary resuscitation (CPR). However, no comprehensive histologic studies of the coronary arteries or the atrioventricular conduction system have been performed to determine whether these structures might be injured by CPR. This report includes a retrospective review of 105 human hearts extensively studied at autopsy after the injection of a colored barium gelatin mass into the coronary arteries. The study group, 83 males and 22 females, included 63 patients (60%) who died in the hospital. Eighty patients (76%) received CPR immediately prior to death. Evidence consistent with direct blunt injury to the coronary arteries and/or the His Bundle was found in 35 (44%) patients who received CPR. These structural changes were characterized by fracture and disruption of the coronary artery wall and/or hemorrhage into the region of the branching His Bundle. Females were significantly older and showed a significantly higher frequency of these lesions than males. Injuries were not related to the site where CPR was administered, in- or out-of-hospital, nor to the duration of CPR. We conclude that CPR is associated with evidence of direct blunt injury to the coronary arteries and/or the His Bundle and proximal bundle branches; and that these lesions may influence the outcome of resuscitative efforts as well as ultimate prognosis.