Sökning: onr:"swepub:oai:DiVA.org:uu-254412" >
Blood flow and perf...
Blood flow and perfusion pressure during open-chest versus closed-chest cardiopulmonary resuscitation in pigs.
-
- Rubertsson, Sten (författare)
- Uppsala universitet,Anestesiologi och intensivvård
-
Grenvik, A (författare)
-
- Wiklund, Lars (författare)
- Uppsala universitet,Anestesiologi och intensivvård
-
(creator_code:org_t)
- 1995
- 1995
- Engelska.
-
Ingår i: Critical Care Medicine. - 0090-3493 .- 1530-0293. ; 23:4, s. 715-25
- Relaterad länk:
-
https://urn.kb.se/re...
Abstract
Ämnesord
Stäng
- OBJECTIVE: To evaluate the blood flow and perfusion pressure differences observed during open- vs. closed-chest cardiopulmonary resuscitation (CPR), including the effects of epinephrine and sodium bicarbonate administration.DESIGN: Prospective, randomized, controlled trial.SETTING: Experimental animal laboratory in a university hospital.SUBJECTS: A total of 35 anesthetized piglets.INTERVENTIONS: After tracheostomy and insertion of arterial, right atrial, and pulmonary arterial catheters, thoracotomy was performed with placement of a pulmonary arterial flow probe and left atrial catheter. Ventricular fibrillation was induced and followed by 15 mins of either open-chest (n = 14) or closed-chest (n = 21) CPR. A 4-min infusion of 50 mmol of sodium bicarbonate or saline was added at the start of CPR. After 8 mins of CPR, 0.5 mg of epinephrine was given intravenously, and after 15 mins, direct current (DC) shocks were used to revert the heart to sinus rhythm.MEASUREMENTS AND MAIN RESULTS: Blood flow was studied using transit-time ultrasound flowmetry. In an extended group, intrathoracic pressure was measured for calculation of transmural pressure. Before epinephrine administration, mean pulmonary arterial flow (cardiac output) was reduced: a) during closed-chest CPR relatively more than pulmonary perfusion pressure but in proportion to systemic perfusion pressure; b) during open-chest CPR relatively less than pulmonary perfusion pressure but still in proportion to systemic perfusion pressure. Epinephrine administration temporarily increased systemic perfusion pressure during both closed- and open-chest CPR but temporarily decreased pulmonary perfusion pressure only during closed-chest CPR. After epinephrine administration, cardiac output temporarily decreased during both closed-and open-chest CPR.CONCLUSIONS: Open-chest CPR resulted in better cardiac output and systemic perfusion pressure than closed-chest CPR. However, cardiac output values obtained with both methods were much lower than previously reported. After epinephrine administration, cardiac output became extremely low with both methods.
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas