关键词： cardiopulmonary resuscitation   rats   ventricular fibrillation   postresuscitation period   mesenteric perfusion   adrenaline/epinephrine   vasopressin   ORGAN BLOOD-FLOW   CARDIOPULMONARY-RESUSCITATION   MESENTERIC HEMODYNAMICS   EPINEPHRINE   PIGS   MODEL   PERFUSION   SHOCK   METABOLISM   INCREASES  

摘要： Background: The use of vasopressin instead of adrenaline/epinephrine during resuscitation improves vital organ perfusion, but the effects on mesenteric perfusion following Successful resuscitation are not fully evaluated. The present study was designed to compare the effects of vasopressin and adrenaline/epinephrine, given to rats during resuscitation from ventricular fibrillation, on to mesenteric ischaemia, as determined by intestinal mucosal tonometer pCO(2) during the post resuscitation period. Methods and results: Male Sprague-Dawley rats (n = 28) were allocated randomly to receive vasopressin (0.8 U/kg) or adrenaline/epinephrine (90 mug/kg) after 5 min of ventricular fibrillation. Precordial chest compression was initiated 4 min after the start of ventricular fibrillation. continued for 4 min, and followed by defibrillation. Seven of 14 (vasopressin) and 12 of 14 (adrenaline/epinephrine) rats were successfully defibrillated (P = 0.10, Fisher's exact test) and observed for 60 min. Intestinal mucosal tonometer pCO(2) measurements before cardiac arrest and 15, 30,and 60 min following return of spontaneous circulation were 47+/-3, 73+/-8, 63+/-7, and 56+/-6 mm Hg in the vasopressin group and 48+/-5, 78+/-7, 67+/-6, and 62+/-6 mm Hg in the adrenaline/epinephrine group (P < 0.05 at 60 min between vasopressin and adrenaline/epinephritic). Right atrial hemoglobin oxygen saturations at these time points were 73+/-5, 51+/-12, 58+/-11, and 63+/-5% in the vasopressin group and 76+/-7, 44+/-10, 52+/-10 and 54+/-8% in the adrenaline/epinephrine group (P < 0.05 at 60 min between vasopressin and adrenaline/epinephrine), Conclusions: We conclude that in this rat model the administration of vasopressin instead of adrenaline/epinephrine for CPR tends to be associated with lower resuscitation success, but less mesenteric ischaemia during the postresuscitation period in successfully resuscitated rats. (C) 2002 Published by Elsevier Science Ireland Ltd.

关键词： 心肺复苏术   剖宫产术   心脏停搏/治疗   分娩并发症/治疗   成年人   女(雌)性   人类   婴儿   新生   妊娠  

关键词： 复苏术   心脏停搏/中西医结合疗法   人类  

关键词： 心脏复苏   生命支持   首选药   急救现场   心脏性猝死   心脏骤停   心肺复苏   自主循环   心脏按压   复苏效果  

摘要： 0 引言 社区出现心脏骤停与心脏性猝死,必须争分夺秒,就地抢救,不宜长途转运,离患者最近的具有就地抢救能力的就是社区医生,所以说社区是第一急救现场,社区医生是第一应诊人,社区的生命支持,是生命恢复极为重要的一个环节。在 CPR支持下,肾上腺素是心脏复苏的首选药,肾上腺素的即时、合理应用是抢救患者的关键。

关键词： 心搏骤停   心肺脑复苏步骤   人工气道   通气   心脏复苏  

摘要： 目的 :评价 A (气道 )、B(呼吸 )、C(循环 )抢救步骤在心肺脑复苏 (CPCR)中的价值。方法 :收集 70例心搏、呼吸骤停行 CPCR患者临床资料 ,分析单纯心脏疾患致心搏、呼吸骤停 (4 4例 )和非单纯心脏疾患致心搏、呼吸骤停 (2 6例 )患者在实施 CPCR过程中采取的 A、B、C顺序及 CAB组依 C AB间隔时间 (<5分钟、5～ 10分钟和 >10分钟 )所分组的各期复苏成功率。结果 :单纯心脏疾患致心搏、呼吸骤停患者中 ,C组 (11例32例次 )各期复苏成功率均 >87.5 %,显著高于其它各组 (P均 <0 .0 1) ;CAB组 (2 4例 )依 C AB间隔时间不等 ,各期复苏成功率不同 ,<5分钟组各期复苏成功率均明显高于 >5分钟组 (P<0 .0 5或 P<0 .0 1) ;AB组(3例 )各期复苏成功率均≥ 6 6 .7%,ABC组 (6例 )各期复苏成功率均≥ 33.3%,均显著高于 CAB组 (P均 <0 .0 1)。非单纯心脏疾患致心搏、呼吸骤停患者中 ,ABC组各期复苏成功率与 CAB组总体成功率比较无显著差异 (P均 >0 .0 5 ) ;CAB组依 C AB间隔时间不等 ,一、二期复苏成功率间均无显著差异 (P均 >0 .0 5 ) ,三期复苏成功率差异显著 ,>10分钟组明显低于 <10分钟组 (P均 <0 .0 1)。结论 :CAB可能是各种原因致心搏骤停患者 CPCR中可取的抢救步骤 ,但 5分钟可能是进行有效人工通气的极限。

关键词： 《国际心肺复苏和心血管急救指南2000》   系列讲座   中毒   心脏急症   治  

摘要： 中毒引起心搏聚停相对少见，但却是40岁以下人群发生心搏聚停的主要原因。在标准心血管急救指南不够理想或适用时，多数人认同的指南是由美国心脏协会（AHA）毒理学工作组修改高级生命支持（ACLS）方案后作为严重中毒治疗的指南。

关键词： 氨茶碱   静注   治疗   心脏骤停   临床观察   心脏复苏  

摘要： 临床实践表明以缓慢性节律为表现的心脏地骤停患者的心肺复苏成功率,明显低于室颤及室扑患者,院内存活率仅为0～3%[1].

关键词： 心肺脑复苏   持续胸外心脏按压   复苏   病例报告  

摘要： 患者,女性,45岁.右乳癌术后10+年,纳差3+天.查体:极度消瘦,生命体征正常,神清.右侧颈胸部皮肤及皮下组织放疗后呈板状改变,触硬.心肺腹、四肢及神经系统无异常,既往史无特殊.诊断:①右乳癌术后;②重度营养不良.因需输入化疗药物及提供静脉高营养做深静脉置管.选择右锁骨下静脉途径,置管不顺利,在操作过程中,病人突然出现呼吸急促,呼吸频率27次/分,双肺可闻及少许哮鸣音.立即停止操作,进行多功能心电监测:SpO245%,快速型心律失常,室速.查体:深昏迷,大动脉搏动消失,无自主呼吸,双侧瞳孔0.5cm,无光反射,且唇发绀,呼吸心跳骤停.

关键词： 心脏骤停   复苏   护理   抢救   治疗  

摘要： 心脏骤停是指原来全身或心脏较好的情况下,意外地突然发生停止搏动故又称心脏性猝死(1).心脏脑复苏(CPCR)是护理抢救心脏、呼吸骤停及保护和恢复大脑功能的急救护理技术.

关键词： in-hospital cardiac arrest   delayed CPR   CARDIOPULMONARY-RESUSCITATION   SURVIVAL  

摘要： Aim: To describe survival after in-hospital cardiac arrest in relation to the interval between collapse and start of cardiopulmonary resuscitation (CPR). Patients: All patients suffering in-hospital cardiac arrest in Sahlgrenska University Hospital in Goteborg, Sweden between 1994 and 1999 in whom resuscitative efforts were attempted and for whom the interval between collapse and start of CPR was known. Methods: Prospective recording of various factors at resuscitation including the interval between collapse and start of CPR. Retrospective evaluation via medical records of patients' previous history, clinical situation prior to cardiac arrest and final outcome. Results: Survival To discharge was 33% among the 344 patients in whom CPR was started within the first minute as compared with 14% among the 88 patients in whom CPR started more than I min after collapse (P = 0.008). The corresponding figures for patients found in ventricular fibrillation was 50 versus 32% (NS); for patients found in pulseless electrical activity 9 versus 3% (NS) and for patients found in asystole 19 versus 0% (NS). Correcting for dissimililarties in the previous history and factors at resuscitation, the adjusted odds ratio and 95% confidence limits for being discharged from hospital when CPR was started within 1 min compared with a later start was 3.06 with 95% confidence limits of 1.59-6.31. Conclusion: Among patients with in-hospital cardiac arrest in whom the interval between collapse and start of CPR was known, we found that in 80% of the cases CPR was started within the first minute after collapse. Among these patients, survival to discharge was twice that of patients in whom CPR was started later. These results highlight the importance of immediate CPR after in-hospital cardiac arrest. (C) 2002 Published by Elsevier Science Ireland Ltd.