4种复苏方法对呼吸骤停猪肺通气的影响观察

目的 观察胸外按压心肺复苏(C-CPR)、经膈肌下抬挤心肺复苏(D-CPR)、腹部按压心肺复苏(A-CPR)和腹部提压心肺复苏(L-CPR)4种复苏方法对呼吸骤停猪通气的影响.方法 健康家猪28只随机分为4组,经静脉推注琥珀胆碱建立猪呼吸骤停模型,于呼吸骤停即刻分别进行C-CPR、D-CPR、A-CPR和L-CPR.复苏2min后停止按压,给予呼吸机辅助呼吸直至实验猪恢复自主呼吸.测定并比较基础状态时和复苏时4种复苏方法产生的潮气量(VT),并计算分钟通气量(MV)；比较各组心率(HR)和平均动脉压(MAP)水平及自主呼吸恢复时间.结果 基础状态下,4组间VT和MV之间差异无统计学意义(P＞0.05).复苏2min时的VT和MV,D-CPR组高于C-CPR组,A-CPR组高于D- CPR组,L-CPR组高于A-CPR组,差异均有统计学意义(P＜0.01).复苏2min时,L-CPR组HR恢复接近于基础值,A-CPR组HR维持在呼吸骤停即刻水平,C-CPR组和D-CPR组HR明显低于基础值(P＜0.01)；复苏2min后给予机械通气,复苏5min时各组HR均接近基础值.结论 在呼吸骤停猪模型中,L-CPR较其他3种CPR法能产生更大的VT和MV.

Effect of four resuscitation methods on ventilation of pigs with respiratory arrest

Objective To observe the effects of four cardiopulmonary resuscitation(CPR) methods on ventilation of pigs with respiratory arrest.The four CPR methods included chest compression CPR(C-CPR),compression under the diaphragm CPR(D-CPR),abdominal compression CPR(A-CPR),and abdominal wall lifting and compression CPR(L-CPR).Methods A total of 28 healthy domestic pigs were randomly divided into four groups.The pig respiratory arrest model was reproduced by intravenous injection of suxamethonium.Instantly after respiratory arrest,one of each CPR method was performed immediately on the respective groups of pigs.After 2 min of CPR,compression was stopped.The experimental pigs were given assisted respiration using a ventilator until autonomous respiration recovered.The tidal volume(VT) in basic status and that during resuscitation by the four respective resuscitation methods was determined,and minute ventilation(MV) was calculated.Furthermore,heart rate(HR),mean arterial blood pressure,and recovery time of autonomous respiration were compared among all groups.Results In basic status,there was no statistical difference(P>0.05) between VT and MV among the four groups.Approximately 2 min after resuscitation,the VT and MV of D-CPR were higher than that of C-CPR;that of A-CPR was higher than that of D-CPR;and that of L-CPR was higher than that of A-CPR.The differences had statistical significance(P<0.01).Within 2 min after resuscitation,HR in L-CPR recovered close to the basic value and HR in A-CPR remained on the level of that of respiratory arrest,but the difference showed no statistical significance(P>0.05).HR in C-CPR and D-CPR were notably lower than the basic value(P<0.01).Within 2 min after resuscitation,mechanical ventilation was given,and HR in all groups were close to the basic value 5 min after resuscitation.In the respiratory arrest pig model,L-CPR could provide more effective VT and MV than the other methods.Conclusion For the porcine respiratory arrest model,L-CPR can provide more effective ventilation than the other methods.