Forensic Aspect of Cause of Subendocardial Hemorrhage in Cardiopulmonary Resuscitation Cases Chest Compression or Adrenaline
Forensic Aspect of Cause of Subendocardial Hemorrhage in Cardiopulmonary Resuscitation Cases Chest Compression or Adrenaline
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DOI：
10.1097/paf.0b013e3181edee46
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发表时间：
2011-03-01
影响因子：
1
通讯作者：
Kaufman, Larry
中科院分区：
文献类型：
--
作者：
Charaschaisri, Werasak;Jongprasartsuk, Kesanee;Kaufman, Larry
脑底出血是法医尸检中常见的一个显著特征。早期人们认为这是一种濒死现象，没有特别提到死亡原因。然而，最新的研究表明，即使是轻微的SEH也可能对心脏功能产生影响，并可能参与死亡机制。为了排除除颤导致SEH的可能原因，在2006年7月至2008年6月期间，对Srinakarinwirot大学医学院法医学系和朱拉隆功大学医学院法医学系收治的240名成年人进行了尸检。将所有受试者分为两组：一组接受复苏，另一组不接受复苏。在前一组中，76例患者尝试使用肾上腺素进行心肺复苏，44例患者未使用肾上腺素。后一组120例未进行复苏。肾上腺素复苏组发生SEH的比例为43.4%（33/76），而无肾上腺素复苏组仅为9.1%（4/76），差异有显著性（P < 0.05）。这表明，在复苏时间延长和肾上腺素利用水平较高的情况下，SEH呈增加趋势。
Subendocardial hemorrhage (SEH) is a striking feature seen in many forensic autopsy cases. It was believed earlier to represent an agonal phenomenon without any particular reference to the cause of death. However, the latest study showed that even minor SEH might have an influence on cardiac function and might be involved in the mechanism of death. To rule out the possible cause of SEH from defibrillation, autopsies were performed in 240 adults admitted to Department of Forensic Medicine, Faculty of Medicine, Srinakarinwirot University and Department of Forensic Medicine, Faculty of Medicine, Chulalongkorn University between July 2006 and June 2008. All the subjects were subdivided into 2 groups: one group receiving resuscitation and the other group receiving no resuscitation. In the former group, 76 patients had attempted cardiopulmonary resuscitation with adrenaline and 44 patients without adrenaline. While in the latter group, 120 patients received no resuscitation attempt. Approximately, 43.4% of resuscitation with adrenaline cases (33/76) demonstrated SEH in contrast to 4 cases of resuscitation without adrenaline (9.1%, P < 0.05). This demonstrates an increasing trend of SEH in cases with prolonged resuscitation and higher level of adrenaline utilizations.