闭胸心肺复苏时主动脉内带水囊导管持续阻塞降主动脉的血流动力学效应

为了提高闭胸心肺复苏时心肌冠状循环灌注压(CPP),我们分别观察了用主动脉内带水囊导管周期性阻塞胸主动脉或腹主动脉(OTA/OAA),以及不同剂量肾上腺素(0.02～0.14mg/kg)对CPP的影响。结果:OTA不能提高CPP。然而,在复苏30min内,每3minOAA之后,CPP都比各期阻塞前血压高0.67～1.2kPa(P<0.05或0.01);解除阻塞3 min后,CPP比各期解除前血压低0.8～1.6kPa(P<0.05或0.01)。另外,使用肾卜腺素只在复苏的前9min有效。结论:OAA可以显著提高闭胸心肺复苏时的CPP;在复苏后期,其作用优于大剂量肾上腺素。

Hemodynamic Response to Continuous Occlusion of Aorta via Intra-aortic Balloon Inflation in Closed Chest Cardiopulmonary Resuscitation

The effects of continuous occlusion of thoracic or abdominal aorta (OTA or OAA) via intra-aortic balloon inflation on coronary perfusion pressure (CPP) were observed in 12 dogs after 10 min of cardiac fibrillation in comparison with those of different doses of epinephrine (0.02~0.14 mg/kg). The results showed that OTA could not increase CPP. However, during 30 min of cardiopu-Imonary resuscitation(CPR), every 3 min of OAA was followed by markedly increased CPP, 067 ~ 12kPa higher than the value in balloon deflation peritxl right before(P<0.05 or 0.01); and 3min after balloon deflation, the CPP reduced significantly, 0.8-1.6 kPa lower than the value right before (P<0.05 or 0.01). Moreover, administration of epinephrine could significantly increase aortic diastolic pressure only in the first 9 min of CPR. It is concluded that OAA could significantly increase CPP in closed chest CPR, and its effect was more potential than that of high dose of epinephrine in prolonged CPR.