低温关胸心肺转流行心肺复苏的实验研究

目的　观察狗心脏停搏15min后深低温(26℃～27℃)和浅低温(33℃～34℃)关胸心肺转流(CPB)对心肺复苏(CPR)的影响。方法　10只麻醉狗，分2组，每组各5只。第1组为浅低温组，第2组为深低温组，用10%氯化钾静注后，使心脏停搏15min，然后用动静脉插管方法立即行关胸心肺转流。第1组食道温度降至33℃～34℃，第2组降至26℃～27℃，15min后逐渐升温至正常范围(36℃～37℃)。复苏期间监测心电图、平均动脉压、中心静脉压和瞳孔直径，3h后观察颅内压和最终效果。结果　第1组全部恢复自主循环(100%)，第2组仅3只(60%)恢复自主循环；第1组的自主循环恢复时间为(444±192.2)sec，明显短于第2组(1980±681.5)sec(P＜0.05)，其复苏后3h颅内压为(2.4±0.44)cmH

Laboratory observation ofresuscitation by closed chest cardiopulmonary bypass with hypothermia after 15 minutescardiac arrest in dogs

Objective To observe the effects of resuscitation by closed chestcardiopulmonary bypass(CPB) with mild and deep hypothermia after 15 minutes cardiac arrest in dogs.Methods Adult normothermia dogs were submitted to 15 minutes cardiac arrest by potassicum chloride induced cardioplegia. Resuscitation was carried out by CPB with mild hypothermia(33～34℃) in group 1(n=5) and with deep hypothermia in group 2(n=5). After 15 minutes, the body temperature were elevated to normothermia. During resuscitation, ECG, mean arterial blood pressure, centrical venous pressure, intracranial pressure and pupils were monitored.Results Outocirculation returned in group 1 were 5 of 5 (100%) and 3 of 5(60%) in group 2. The returned outocirculation time were (444±192.2)seconds in group 1, significantly faster than (1 980±681.5) seconds in group 2 (P＜0.05). Intracranial pressure in group 1 were (2.4±0.44)cmH2O, significantly lower than (11.2±3.76)cmH2O in group 2(P＜0.05).Conclusion The outocirculation returned by CPB with mild hypothermia more effective than with deep hypothermia after 15 minutes cardiac arrest in dogs.