摘要
:目的 :通过心肺复苏期间对心脏氧利用率 (O2 UCc)的测量来评估心脏复跳的可能性。方法 :19例患者分别为 , 冠心病组 10例 ,男 8例 ,女 2例 ,年龄 36～ 6 2 (4 9.5± 10 .3)岁 ,血流动力学稳定 ,插入右心导管取冠状窦静脉血标本。 心肺复苏组 9例 ,男 8例 ,女 1例 ,年龄 2 0～ 70 (39.0± 15 .5 )岁 ,心脏停跳后 ,先按照标准心肺复苏步骤行胸外心脏按压抢救 2 0分钟 (胸外按压频率 12 0～ 140次 / min,血管活性药用药间隔为 2分钟 ,应用 4%碳酸氢钠液 2 5 0～ 5 0 0 m l)。如心脏未复跳 ,再继续开胸心脏按压复苏 2 0分钟 (按压频率为 80～10 0次 / m in)。此间用呼吸机控制呼吸 ,维持动脉血氧饱和度 (Sa O2 ) 0 .90 0以上。抢救停止后即刻抽取冠状静脉血和动脉血。所有血标本均即刻进行血气分析 ,并计算心脏氧利用率〔O2 UCc=(Sa O2 Sv O2 ) / Sa O2 〕。根据所得结果分析其对心肺复苏预后的预测价值。结果 : 组患者冠状静脉窦血的血气分析结果 :Pa O2 (4 .2 0±0 .41) k Pa(1k Pa=7.5 mm Hg) ,Sa O2 0 .5 32± 0 .0 90 ,O2 U Cc为 0 .46± 0 .0 9; 组患者 O2 U Cc=0 .85± 0 .11,其中 4例心脏复跳者 O2 UCc=0 .78± 0 .10 ,5例无效者 O2 UCc=0 .91± 0 .0 7,二者比较差异有显著性 (P<0 .0 0 1)。结论 :
Objective:To evaluate the prognostic value of cardiac oxygen utilization coefficient (O 2UCc) during cardiopulmonary resuscitation (CPR).Methods:Nineteen cases were divided into two groups.Group 1 consisted of 10 patients 〔male 8,femal 2,aged 3662(49 5±10 3) years〕with coronary heart disease.Their hemodynamics were stable and the blood samples were taken with the aid of coronary sinus cannula for blood gas analysis.Group 2 consisted of 9 cases 〔male 8,female 1,aged 2070(39.0±15.5) years〕 who were resuscitated by the closed chest cardiac massage for 20 minutes(frequency of massage was 120140 beats/min,the intermittent time of drugs administration was 2 minutes,venous transfusion 4% sodium bicarbonate 250 500 ml )and followed by open chest cardiac massage (80100 beats/min) for 20 minutes if heart beat was not restored.The coronary venous blood was taken at the end of the CPR.The O 2UCc was calculated.Results:Plasma concentrations of O 2,oxygen saturation(SaO 2),and O 2UCc in group l were(4.20±0.41)kPa (1 kPa=7 5 mmHg),0 532±0 090,0.46±0.09,respectively.In group 2,O 2UCc was 0.85±0.11,and there was a significant difference between the 4 patients in whom the heart beat restored and the 5 with no heart beat restoration (0 78±0 10 vs.0 91±0 07, P <0 001).Conclusions:The possibility of restoration of heart beat exist when O 2UCc is 0 650 91 and the time interval between the onset of cardiac arrest to the CPR is no longer than 30 minutes.O 2UCc reflect preservation of the myocardium and thus is a good predictor of the heart oxygen metabolism during CPR and cardiac bypass.
出处
《中国危重病急救医学》
CAS
CSCD
2000年第11期669-671,共3页
Chinese Critical Care Medicine
关键词
心肺复苏
心脏氧利用率
心脏复跳
cardiopulmonary resuscitation
cardiac oxygen utilization coefficient
