Hyperventilation-induced hypotension during cardiopulmonary resuscitation
Hyperventilation-induced hypotension during cardiopulmonary resuscitation
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DOI：
10.1161/01.cir.0000126594.79136.61
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发表时间：
2004-04-27
期刊：
影响因子：
37.8
通讯作者：
Lurie, KG
中科院分区：
文献类型：
--
作者：
Aufderheide, TP;Sigurdsson, G;Lurie, KG
一项临床观察研究显示，在院外心肺复苏（CPR）过程中，救援人员始终过度通气患者。本研究的目的是量化过度通气在人类的程度，并确定如果在动物心肺复苏术的过度通气率相比显着降低冠状动脉灌注压和survival.Methods和结果，在人类，心肺复苏术的通气率和持续时间是电子记录的专业救援人员。在13名连续接受心肺复苏术（7名男性）的成人（平均年龄63 ± 5.8岁）中，平均通气率为30 ± 3.2/min（范围15 - 49）。每次呼吸的平均持续时间为每秒1.0 +/- 0.07。无患者存活。在9只心脏骤停的猪中以随机顺序以每分钟12、20或30次呼吸进行通气，研究血液动力学。然后在3组7只心脏骤停的猪中研究了存活率，这些猪以每分钟12次呼吸（100% O-2）、每分钟30次呼吸（100% O-2）或每分钟30次呼吸（5% CO2/95% O-2）通气。在每分钟呼吸12次、20次和30次的动物中，平均胸内压（mm Hg/min）和冠状动脉灌注压（mm Hg）分别为7.1 ± 0.7、11.6 ± 0.7、17.5 ± 1.0（P
Background-A clinical observational study revealed that rescuers consistently hyperventilated patients during out-of-hospital cardiopulmonary resuscitation (CPR). The objective of this study was to quantify the degree of excessive ventilation in humans and determine if comparable excessive ventilation rates during CPR in animals significantly decrease coronary perfusion pressure and survival.Methods and Results-In humans, ventilation rate and duration during CPR was electronically recorded by professional rescuers. In 13 consecutive adults (average age, 63 +/- 5.8 years) receiving CPR (7 men), average ventilation rate was 30 +/- 3.2 per minute (range, 15 to 49). Average duration per breath was 1.0 +/- 0.07 per second. No patient survived. Hemodynamics were studied in 9 pigs in cardiac arrest ventilated in random order with 12, 20, or 30 breaths per minute. Survival rates were then studied in 3 groups of 7 pigs in cardiac arrest that were ventilated at 12 breaths per minute (100% O-2), 30 breaths per minute (100% O-2), or 30 breaths per minute (5% CO2/95% O-2). In animals treated with 12, 20, and 30 breaths per minute, the mean intrathoracic pressure (mm Hg/min) and coronary perfusion pressure (mm Hg) were 7.1 +/- 0.7, 11.6 +/- 0.7, 17.5 +/- 1.0 (P