Central apnea and acute cardiac ischemia in a sheep model of epileptic sudden death
Central apnea and acute cardiac ischemia in a sheep model of epileptic sudden death
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DOI：
10.1002/ana.410420409
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发表时间：
1997-10-01
影响因子：
11.2
通讯作者：
Laxer, KD
中科院分区：
文献类型：
--
作者：
Johnston, SC;Siedenberg, R;Laxer, KD
癫痫患者猝死的病因尚不清楚。先前在建立的绵羊癫痫持续状态模型中的研究表明，超过三分之一的未服用镇静剂的动物在癫痫发作后5分钟内因呼吸不足而死亡。不能确定气道阻塞和中枢性低通气量的相对贡献，因为没有监测现在的气道和呼吸努力。在本研究中，通过心电图仪、脑电图仪、动脉线、连续血气和呼吸道流量计监测，在未用药的绵羊气管切开术中诱发癫痫持续状态。所有8只动物都表现出中枢性呼吸暂停和换气不足，导致1只死亡，另一只死亡。第三只动物在癫痫发作后2分钟内死于急性心力衰竭，并伴有巨大的间隔心肌出血、收缩带和全球心肌缺血的迹象。在其他动物身上也发现了更细微的收缩带、心内膜下出血和急性心肌缺血的迹象，没有一只动物死于心脏原因。所有绵羊均未出现恶性心律失常。中枢性低通气量和呼吸暂停伴随全身性癫痫持续状态，可能是癫痫患者猝死的重要原因。急性心力衰竭也可能是癫痫猝死的原因之一。
The etiology of sudden death in patients with epilepsy remains unclear. Previous studies in a well-established sheep model of status epilepticus showed that more than one-third of the unsedated animals died within 5 minutes of seizure onset due to hypoventilation. The relative contributions of airway obstruction and central hypoventilation could not be determined because airway now and respiratory effort were not monitored. In this study, status epilepticus was induced in unsedated sheep with tracheostomies monitored by electrocardiography, electroencephalography, arterial line, serial blood gases, and airway flowmeter. All 8 animals demonstrated central apnea and hypoventilation, which resulted in the death of 1 and contributed to the death of another. A third animal died of acute heart failure within 2 minutes of seizure onset, accompanied by a large septal myocardial hemorrhage, contraction bands, and signs of global cardiac ischemia. More subtle contraction bands, subendocardial hemorrhage, and signs of acute myocardial ischemia were seen in other animals as well, none of which died of cardiac causes. Malignant arrhythmia was not seen in any of the sheep. Central hypoventilation and apnea accompany generalized status epilepticus and may be an important cause of sudden death in epileptics. Acute cardiac failure may also be a cause of epileptic sudden death.