关键词： cardiac arrest   cardiopulmonary resuscitation   external chest compressions   MITRAL-VALVE FUNCTION   BLOOD-FLOW   TRANSESOPHAGEAL ECHOCARDIOGRAPHY   INTRATHORACIC PRESSURE   DOGS   COMPRESSION   CPR   PHYSIOLOGY   SEQUENCE   MASSAGE  

摘要： The mechanism of forward blood flow during cardiopulmonary resuscitation (CPR) remains controversial. We hypothesized that, if the heart acts as a pump, the proximal descending thoracic aorta would be distended during compression by forward blood flow, and would be constricted or remained unchanged if blood flow is generated by increased intrathoracic pressure. Fourteen patients with nontraumatic cardiac arrest underwent transesophageal echocardiography to verify changes in the descending thoracic aorta during standard manual CPR. The aortic dimensions, including cross-sectional area and diameter at the end of compression and relaxation, were measured proximal to, and at the maximal compression site of the descending thoracic aorta. At the maximal compression site, deformation of the descending thoracic aorta was observed during compression in all patients and the ratio of maximal to minimal diameter of the aorta (deformation ratio) decreased during compression compared with relaxation (0.58 +/- 0.15 vs. 0.81 +/- 0.11, P = 0.001). This suggests eccentric compression of the descending thoracic aorta by external chest compression. The deformation ratio of the descending thoracic aorta proximal to the maximal compression site remained unchanged during compression and relaxation (1.0 +/- 0.88 vs. 1.0 +/- 0.9, P = 0.345). The cross-sectional area of the descending thoracic aorta proximal to the maximal compression site increased 15% on average during compression compared with relaxation in 12 of 14 patients. In conclusion, deformation of the aorta at the maximal compression site and increase in the cross-sectional area of the proximal aorta suggests that cardiac pumping is the dominant mechanism in generating forward blood flow during CPR in humans. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

关键词： ventricular fibrillation   defibrillation   N(alpha)-histogram   ECG-signal analysis   vasopressin   epinephrine   CORONARY PERFUSION-PRESSURE   CARDIAC RESUSCITATION   COUNTERSHOCK SUCCESS   MYOCARDIAL PERFUSION   PORCINE MODEL   VASOPRESSIN   EPINEPHRINE   FREQUENCY   ARREST   ASSOCIATION  

摘要： Mean fibrillation frequency may predict defibrillation success during cardiopulmonary resuscitation (CPR). N(alpha)-histogram analysis should be investigated as an alternative. After 4 min of cardiac arrest, and 3 versus 8 min of CPR, 25 pigs received either vasopressin or epinephrine (0.4, 0.4, and 0.8 U/kg vasopressin versus 45, 45, and 200 mug/kg epinephrine) every 5 min with defibrillation at 22 min. Before defibrillation, the N(alpha)-parameter histogramstart/histogramwidth and the mean fibrillation frequency in resuscitated versus non-resuscitated pigs were 2.9 +/- 0.4 versus 1.7 +/- 0.5 (P = 0.0000005); and 9.5 +/- 1.7 versus 6.9 +/- 0.7 (P = 0.0003). During the last minute prior to defibrillation, histogramstart/histogramwidth of greater than or equal to 2.3 versus mean fibrillation frequency ! 8 Hz predicted successful defibrillation with subsequent return of a spontaneous circulation for more than 60 min with sensitivity, specificity, positive predictive value and negative predictive value of 94 versus 82%, 96 versus 89%, 98 versus 93% and 90 versus 74%, respectively. We conclude, that N(alpha)-analysis was superior to mean fibrillation frequency analysis during CPR in predicting defibrillation success, and distinction between vasopressin versus epinephrine effects. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

关键词： 呼吸心跳停止   抢救   心脏复苏   病例报告  

摘要： 1 病例报告患者男,18岁,南方新战士。咽痛、声音嘶哑半年,头痛、鼻塞、畏寒3天,曾自服'金嗓子喉宝'数次。于2000—02—20 16:00在越野时突感轻度呼吸困难,当时未介意,饭后呼吸困难加重,随即由战友背来团卫生队。查体:脉搏46/min,血压8.7/5.7 kPa(65/43mmHg)。浅昏迷,耳廓、口唇中度紫绀,双侧瞳孔对光反射迟钝,锁骨上窝、胸骨上窝、肋间隙及上腹部凹陷,并伴有吸气性喘鸣及犬吠样咳嗽。继而患者意识丧失,呼吸停止,立即'口对口'人工呼吸,同时肌注尼可刹米0.375g,约5min 后,呼吸未恢复,心跳停止,

关键词： 心搏呼吸骤停   心脏复苏  

摘要： 患者,男,46岁,农民.因'5年内夜间反复发作性晕厥3次'入院.查体:血压14/8kPa(1kPa＝7.5mm Hg),脉搏60次/min.两肺无殊;心界略向左下扩大,心律60次/min,律齐,各瓣膜区未闻及病理性杂音;腹部无殊.辅助检查:心脏彩超示左房、右房、左室扩大.心脏电生理检查示:①AV时间和HV时间延长;②窦房结传导时间延长.入院诊断:扩张性心肌病,窦房结功能减退,心源性晕厥.

关键词： 心脏紧急救治   心肺复苏   国际指南2000  

摘要： 一、新指南的由来美国有关心脏紧急救治(emergency cardiac care,ECC)和心肺复苏(cardiopulmonary resuscitation,CPR)的指南(简称指南),原由美国心脏病学会(American heart association,AHA),及其下属的各个专业委员会共同负责,先后多次出版,1992年公布新的指南,鉴于近几年来,这方面又有了不少进展和新的认识,故AHA于1998年开始着手进行指南的再次修订,并确定将指南于2000年修订成国际指南(简称新指南)的目标.

关键词： 心脏骤停   心脏复苏   抢救  

摘要： 心脏骤停是临床上经常遇到的急症之一,稍一疏忽患者就会失去生命.我科自1994年2月～1996年2月共收治心脏骤停病人34例,其中21例复苏成功.实践证明:有效的心肺复苏越早,存活率越高,神经系统的后遗症也越少.

关键词： 心脏骤停   心肺复苏   急救   电除颤  

摘要： 作者自1997年以来,以电除颤为主要复苏手段对24例心脏骤停患者进行复苏,现总结如下.

关键词： 布比卡因/副作用   复苏术   心脏停搏/病因学   心脏停搏/化学诱导   人类  

关键词： 心脏骤停   心肺复苏   抢救  

摘要： 因心脏疾患如冠心病、心肌病、主动脉狭窄或关闭不全、二尖瓣脱垂、预激综合征和一些非心脏疾患,如主动脉夹层分离、代谢与电解质紊乱、急性酒精中毒、雷击、溺水、窒息等均可以引起心脏骤停.一旦确诊为心脏骤停,立即在现场施行心肺复苏术(CPR).正确的CPR技术是挽救患者生命的关键.现将我们抢救20例患者情况分析如下.

关键词： 急性海洛因中毒   心脏复苏   电机械分离   急救  

摘要： 急性海洛因中毒的病例并不少见,现将我院急诊科近年救治13例急性海洛因中毒电-机械分离患者的资料报告如下.