アセンディング・ランプの二相波形は,低度の除細動値を持ち,断絶された指数関数二相波形よりも少ないトロポニンIを放出します
Jian Huang1, Gregory P Walcott, Richard B Ruse
1University of Alabama-Birmingham, 1670 University Blvd, Room B140 Volker Hall, Birmingham, AL 35294-0019, USA. jh@crml.uab.edu
Circulation
|August 7, 2012
まとめ
電気ショック波の形状は,デフィブリレーションの成功と心臓損傷に大きな影響を与えます. 上昇するランパの波形は,より低い除細動エネルギー需要とより少ないトロポニンIの放出を示し,心筋損傷の減少を示しています.
科学分野:
- 心臓病学 心臓病学
- バイオメディカルエンジニアリング
- 電気生理学 電気生理学
背景:
- 電動除細動の有効性は,衝撃波の形状の特性によって影響を受けます.
- 波形の形が除細動の値と心臓損傷にどのように影響するかを理解することは,蘇生プロトコルを最適化するために重要である.
研究 の 目的:
- 衝撃波の形状が除細動の値と心臓損傷の両方に影響するという仮説を調査する.
- 様々な電気ショック波形に関連した除細動の有効性と心筋膜損傷を比較する.
主な方法:
- 豚における11の異なる波形 (上昇,下降,直線二相,グルヴィッチ,短縮指数二相) に対して,デフィブリレーションの値を決定した.
- デフィブリレーションを誘発するために1回の約30-Jのショックを与え,心臓損傷を評価するためにショック後のトロポニンIの血中濃度を測定しました.
主要な成果:
- 8ミリ秒の上昇ルンパの波形は,最も低い défibrillation 値 (14.6±7.3 J) を示しました.
- アセンディング・ランプの波形は,ショックの6時間後のトロポニンI濃度 (0.80±0.54 ng/mL) を大幅に低下させ,断絶指数 (1.92±0.47 ng/mL) と直線波形 (1.17±0.45 ng/mL) と比較した.
結論:
- 昇降式ランパの波形は,より低い défibrillation 値を示し,切断された指数関数双相ショックと比較して,かなり少ない心損傷 (58%少ないトロポニン I 放出量) を引き起こします.
- 衝撃波の形状の特徴は,除細動の効果と心筋膜損傷の程度の両方に重要な役割を果たします.
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