心肺蘇生時の高呼吸で引き起こされた低血圧
Tom P Aufderheide1, Gardar Sigurdsson, Ronald G Pirrallo
1Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, USA.
Circulation
|April 7, 2004
まとめ
心肺蘇生 (CPR) 中の過度の換気は一般的です. 動物の研究は,高呼吸が冠動脈 perfusion 圧力と生存率を大幅に低下させることを示し,改善されたCPR技術に対する重大な必要性を強調しています.
科学分野:
- 緊急医療 緊急医療
- 心肺生理学 心肺生理学
- 蘇生科学 蘇生科学とは
背景:
- 観察研究は,病院外心肺蘇生 (CPR) 中の救助隊員による頻繁な高呼吸を示しています.
- 過剰な換気は,蘇生作業中の患者の結果に悪影響を及ぼす可能性があります.
研究 の 目的:
- 人間のCPRにおける過度の換気の程度を定量化するために.
- 動物モデルにおける過度の換気率が,心肺蘇生時の冠動脈 perfusion 圧力および生存率を低下させるかどうかを判断する.
主な方法:
- 呼吸速率と持続時間は,心肺蘇生療法を受けた13人の成人の患者で電子的に記録されました.
- 血液動力学的パラメータと生存率は,CPRを施した豚で,換気速度の変動 (12, 20, 30呼吸/分) とガス混合物で評価されました.
主要な成果:
- 人間のCPRは,平均呼吸速度は30呼吸/分であり,生存者はいなかった.
- 豚では,換気速度の増加 (30対12呼吸/分),胸内圧の有意な上昇 (17.5対7.1mmHg/分),冠動脈の輸血圧の低下 (16.9対23.4mmHg) が示されました.
- 豚の生存率は,30呼吸/分 (1/7) と12呼吸/分 (6/7) と比較して,著しく低かった.
結論:
- プロの救助隊員は,病院外での心肺蘇生 (CPR) の際に患者を頻繁に高呼吸させます.
- 動物モデルにおける心肺蘇生中の過度の換気は,有害な血液動力学的変化と生存率の低下につながる.
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