長期にわたる心房細動の治療. 即時の反撃と,高用量のエピネフリンと,反撃に先立つ心肺蘇生 (CPR) との対比

J T Niemann¹, C B Cairns, J Sharma

¹Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance 90509.

Circulation

|January 1, 1992

まとめ

静脈細動の早期除細動は効果的ではないかもしれません. カウンターショックの前に高用量のエピネフリンと心肺蘇生 (CPR) を提供することは,犬のモデルで心停止蘇生の結果を大幅に改善します.

科学分野:

心臓病学心臓病学
緊急医療緊急医療
獣医医学獣医医学は,獣医医学というものです.

背景:

早期の除細動は,心停止の結果を改善します.
長期にわたる心房細動は,しばしばアシストールまたは反衝撃後の非貫通リズムにつながります.
高用量のエピネフリンは,心肺蘇生 (CPR) 中の輸血を高めます.

研究の目的:

高用量のエピネフリン療法による即時反ショックと,抗ショック前の従来の心肺蘇生との間の心臓蘇生結果を,長時間の心房細動症の犬のモデルで比較する.

主な方法:

28匹の犬で心房細動が誘発されました.
動物は,即時の反衝撃を受け,その後,心臓の生命維持機能 (ACLS) が強化されたか,または,反衝撃とACLSの前に,高用量のエピネフリンとCPRを受けた.
蘇生の結果と冠動脈輸血圧は,グループごとに比較された.

主要な成果:

反ショック前 (9/14) にエピネフリンとCPRを投与された犬の比率が,即時の反ショック (3/14) に比べて,自発的な perfusing リズムが回復した犬の比率が著しく多かった.
逆震前の冠動脈の輸血圧は,エピネフリンとCPR群で有意に高かった.
p = 0.014 蘇生成功について.

結論:

カウンターショックの前の短期間,高用量のエピネフリンとCPRによる心筋膜 perfusionは,長時間の心房細動から心臓蘇生結果を改善します.

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