心肺复苏期间动静脉血的酸碱差异

采用血气分析测定ＣＰＲ期间患者动静脉血的酸碱状态。结果发现，ＣＰＲ期间患者动静脉血酸碱差异增大，动脉血呈呼吸性碱中毒趋势，而静脉血呈高碳酸血症。作者认为ＣＰＲ期间动脉血气不能真实反映患者体内酸碱状态，需结合静脉血气综合考虑。文中对ＣＰＲ期间纠正酸中毒的药物应用及选择等进行了讨论。

ARTERIOVENOUS ACID BA8SE DISPAPITY DURING CARDIOPULMONARY RESUSCITATION

rteriovenous acid-base disparity was studied in 10 critically ill patients during car-diopulmonary resuscitation(CPR ).In this period,the arterial blood pH averaged 7.41, whereas the average central blood pH was 7.16(P<0.01).The mean arterial partial pressureof carbon dioxide(PaCO2)was 4.54 kPa,but the average central pressure of carbon dioxide(PvCO2)was 8.67 kPa(P<0.01).In half of the patients whose blood gases wrer measuredbefore,as well as during the cardiac arrest,arterial pH,PCO2 and bicarbonate were notsingnificantly changed during CPR. However,central venous blood demonstrated strikingdecreases in pH (P<0.05),nd increases in PvCO2(P<0.05).Our findings indicate thatcentral venous blood most accurately reflects the acid-base state during CPR,especially therapid increase in PCO2 Arterial blood does not reflect marked reduction in central venous andtissue pH,thus arterial gases may fail to serve as appropriate guides for acid-base manage-ment during CPR.