Association of delay to first intervention with return of spontaneous circulation in a swine model of cardiac arrest
Association of delay to first intervention with return of spontaneous circulation in a swine model of cardiac arrest
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DOI：
10.1016/j.resuscitation.2006.07.029
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发表时间：
2007-04-01
期刊：
影响因子：
6.5
通讯作者：
Callaway, Clifton W.
中科院分区：
文献类型：
--
作者：
Rittenberger, Jon C.;Menegazzi, James J.;Callaway, Clifton W.
目的：尽管在动物研究中取得了成功，但没有单一药物可以提高心脏骤停后的生存率。我们试图确定循环停止的持续时间，在此之后最大。药物治疗和抢救休克将fait实现自主循环的恢复（ROSC）。设计/主题：回顾性分析271头猪（20-30公斤）在心室颤动期间的复苏尝试。方案分为五类：立即抗休克、标准剂量药物心肺复苏（CPR）、单独CPR、CPR和高剂量肾上腺素（CPR + HDE）（0.1 mg/kg）以及心得安（1 mg）、肾上腺素（肾上腺素）（0.1 mg/kg）和加压素（40 IU）混合药物（CPR + DC）。使用logistic回归和Hosmer-Lemeshow拟合检验，将首次CPR时间、首次给药时间、首次休克时间和治疗方案作为ROSC的预测因素进行检查。主要结果：271头猪中有119头（44%）发生了ROSC。首次给药时间和CPR + DC组是ROSC的预测因素。至首次CPR的时间、CPR + DC组和CPR + HDE组也是ROSC的预测因子。至首次抢救休克的时间、CPR + DC组和CPR + HDE组是ROSC的预测因素。在CPR + DC组中，50%的ROSC发生在第一次CPR时间13.4 min，第一次药物时间14.1 min和第一次抢救性休克时间17.5 min。CPR + DC的电击前递送增加了ROSC的可能性，并达到50%的药物输送时间为14.1分钟。50%的ROSC率可以实现使用优化复苏实验CPR。(c)2006爱思唯尔爱尔兰有限公司保留所有权利。
Objective: No single drug improves survival after cardiac arrest, despite success in animal studies. We sought to determine the duration of circulatory arrest after which maximal. drug treatment and a rescue shock would fait to achieve return of spontaneous circulation (ROSC).Design/Subjects: Retrospective analysis of 271 swine (20-30 kg) resuscitation attempts during ventricular fibrillation. Protocols were divided into five categories: immediate countershock, cardiopulmonary resuscitation (CPR) with standard-dose drugs, CPR alone, CPR and high-dose epinephrine (CPR + HDE) (0.1 mg/kg), and CPR with a drug cocktail (CPR + DC) of propanolol (1 mg), epinephrine (adrenaline) (0.1 mg/kg) and vasopressin (40 IU). Time to first CPR, time to first drug administration, time to first shock, and protocol were examined as predictors of ROSC using logistic regression with Hosmer-Lemeshow test of fit. Probability of ROSC was calculated from logistic curves.Main results: ROSC occurred in 119 of the 271 swine (44%). Time to first drug and the CPR + DC group were predictors of ROSC. Time to first CPR, the CPR + DC group, and the CPR + HDE group were also predictors of ROSC. Time to first rescue shock, the CPR + DC group, and the CPR + HDE groups were predictors of ROSC. In the CPR + DC group, 50% ROSC occurred at a first CPR time of 13.4 min, first drug time of 14.1 min and first rescue shock time of 17.5 min.Conclusions: Pre-shock delivery of CPR + DC increases the likelihood of ROSC, and reaches 50% with a time of drug delivery of 14.1 min. ROSC rates of 50% may be achievable using an optimized resuscitation in experimental CPR. (c) 2006 Elsevier Ireland Ltd. All rights reserved.