心肺蘇生時換気法としてのConstant-Flow Ventilationの研究

心肺复苏时恒流通气通气方法的研究

• 批准号: 63570730
• 负责人: 岡元 和文
• 金额: $ 0.83万
• 依托单位: Kumamoto University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1988
• 资助国家: 日本
• 起止时间: 1988 至 无数据
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-63570730/
• 关键词: 心肺蘇生; 心停止; 人工呼吸; 定常流換気; 気管内吹送法

雑種成犬を用い一本の吹送管を用いた定常流換気法(CFV)が、心肺蘇生時および蘇生直後の緊急換気手段として有用か否か検討してみた。方法:麻酔下成犬18頭に気管切開を施行し、切開口より内径2mmの吹送管を気管分岐部1cm直上部に挿入固定した。吹送管の近位端は酸素流量計(アコマ特型)に接続した。電気的心室細動を誘発し、心室細動5分後より80〜100回/分の胸壁圧迫心マッサージとCFVを開始した。CFVは、A群6頭には1.0L/Kg/分、B群6頭には0.5L/Kg/分、C群6頭には0.2L/Kg/分とした。蘇生開始10分後、直流除細動を施行し、蘇生例はそのまま同じ流量のCFVを10分間続けた。その後気管切開部に通常の気管チューブを挿入し純酸素による間欠的陽圧呼吸を15分間施行した。なお、蘇生中は収縮期血圧を100mmHg以上に保つようにアドレナリンを投与し、輸液は生理食塩水3ml/Kg/分とし、重炭酸およびカルシウムの投与は行はなかった。実験中、心電図、気道内圧、大腿動脈圧、直腸温度は連続モニターし、個々の記録および血液ガス測定は、心室細動前、細動後1、5分、心マッサージとCFV開始1、5、10分、蘇生後1、5、10分、間欠的陽圧呼吸後5、10、15分とした。統計処理は、コントロール値に対して各群でpaired t-testを、各群間で一元分散分析を用いた。結果:心マッサージ施行中0.5と1.0/Kg/分のCFVでは適正な動脈血酸素加と低PaCO_2血症が維持できた。しかし、0.2/Kg/分のCFVでは適正なPaCO_2を維持できなかった。蘇生後はどのガス流量でも酸素加を適正に維持できたが、軽度の高PaCO_2血症は避けられなかった。結語:CFV0.5と1.0L/Kg/分は犬の心肺蘇生時に適正なガス交換を維持できることを示した。CFVは蘇生後の換気法としては酸素加は維持できるがPaCO_2の上昇を漸次招くので注意を要する。心肺蘇生に際して、間欠的陽圧呼吸が困難な時、CFVは間欠的陽圧呼吸に代わる新しい換気法と考える。

Several kinds of adult dogs use a book of blow tube to use the steady flow test (CFV) method, and the cardiopulmonary bypass is used to determine whether it is useful. Methods: under the anaesthesia, the 18-year-old adult dog tube was cut and cut through the inner diameter of the 2mm blow pipe, the bifurcation part of the 1cm pipe was inserted into the fixed plate. The proximal end of the blow pipe is connected with the acid flow meter (special type). After 5 minutes of ventricular manoeuvre, the heart wall of the chest wall was forced to start CFV. The scores of CFV, group A, group B, group B and group C were 6, 6, and 6, respectively, and the scores of group A, group A, group B, group C and group C were respectively CFV, 6, 6, 6 and 6, respectively. The 0.2L/Kg/ score of group C was higher than that of group B. After 10 minutes of the start of the operation, the operation will be carried out except for the operation of the direct current, and the flow rate of the same amount of CFV will be adjusted after 10 minutes. In the open section of the tube, the tube is usually operated within 15 minutes of the normal breathing temperature due to the high concentration of sodium. The blood samples were collected during the period of birth and death, the blood samples were higher than 100mmHg, the liquid was divided into 3ml/Kg/, and the heavy carbonic acid was added to the diet water. Midday, ECG, trachea, thigh exercise, direct temperature monitoring, blood test, ventricular exercise, 1, 5 minutes after exercise, heart attacks 1, 5, 10 minutes, postnatal 1, 5, 10 minutes, 5 minutes, 10 minutes, 15 minutes, 5 minutes, 10 minutes, 10 minutes, 5 minutes, 10 minutes, 15 minutes, Statistics and statistics are used to analyze the paired t-test of each group and the univariate dispersion analysis of each group. Results: during the implementation of cardiac surgery, 0.5 1.0/Kg/ score was used to maintain the level of serum acid plus hypoPaCO_-2 in patients with CFV. The CFV of 0.2/Kg/ is in the process of maintaining the performance of the system. In postnatal life, the flow rate of acid was increased and the levels of hyperlipidemia (PaCO_-2) were significantly higher than those of normal controls. Results: CFV 0.5-1.0L

项目成果

Kazufumi Okamoto,et al: Journal of Anesthesia. 3. 16-22 (1989)

Kazufumi Okamoto 等人：麻醉杂志。