Clinical and Experimental Studies on Electromechanical Dissociation
Clinical and Experimental Studies on Electromechanical Dissociation
复制标题
机电分离的临床和实验研究
DOI：
10.1161/01.cir.64.1.18
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发表时间：
1981
期刊：
影响因子：
37.8
通讯作者：
R. Silverberg
中科院分区：
文献类型：
--
作者：
J. Vincent;L. Thijs;M. Weil;S. Michaels;R. Silverberg
Electromechanical dissociation (EMD) is the most frequent cause of unsuccessful cardiac resuscitation in critically ill patients. In a clinical study of cardiac arrest, including 54 episodes in 50 fully monitored patients, 14 episodes of ventricular fibrillation were observed and seven were reversed. In the remaining 40 instances, 36 cases of EMD were initially observed. Four patients had asystole. None of the patients with EMD or asystole were successfully resuscitated.For objective study of EMD and its treatment, we developed an experimental model in which ventricular fibrillation was induced in mechanically ventilated dogs. EMD was predictably observed when, after an interval of 120 seconds, ventricular fibrillation was reversed with an external countershock. Neither metabolic acidosis nor metabolic alkalosis modified the incidence of EMD. A few dogs were pretreated with glucose-insulin- potassium or pharmacologic doses of methylprednisolone, but this did not clearly reduce the incidence of EMD. However, the onset of EMD was delayed when the body temperature of the animal was spontaneously reduced.
