摘要
目的评价大剂量肾上腺素对大鼠心肺复苏后脑氧合功能的影响。方法雄性Wistar大鼠83只,体重200～280 g,随机分为3组:假手术组(C组,n=25)、标准剂量肾上腺素组(S组,n= 31)、高剂量肾上腺素组(H组,n=27)。腹腔注射10％水合氯醛350mg／kg麻醉,气管切开后行机械通气,游离右侧颈内静脉用于采血,游离左侧颈总动脉,持续监测颈动脉血流,双侧股动脉置管,用于监测平均动脉压、采血及给药。机械通气15min时,采用窒息致心跳骤停,心跳骤停10min时,经主动脉注入由窒息前采集的氧合动脉血与肝素、碳酸氢钠0．1 mEg／100 g和2μg／100 g肾上腺素(S组)／或20μg／100 g肾上腺素(H组)的混合液进行复苏。S组不予采血、窒息、复苏。分别于自主循环恢复(复苏)后30、60、120min时采集动、静脉血,进行血气分析,计算颈动-静脉血氧含量差[C(a-jv)O2]、脑氧摄取率(CEO2)。结果与S组比较,H组复苏成功率差异无统计学意义,复苏开始到复苏的时间缩短(P<0．05)。与C组比较,S、H组复苏后5 min时颈动脉血流升高,复苏后15～120 min时颈动脉血流降低(P<0．01),CEO2、C(a-jv)O2复苏后各时点均升高,但H组低于S组(P<0．05)。结论与标准剂量肾上腺素比较,大剂量肾上腺素降低了脑氧摄取。
Objective To evaluate the effect of high-dose epinephrine given during cardiopulmonary resuscitation （CPR） on cerebral oxygenation. Methods Eighty-three male Wistar rats （200-280 g） were randomly divided into 3 groups： group Ⅰ control （C, n = 25） ; group Ⅱ standard-dose epinephrine （S, n = 31） and group Ⅲ high-dose epinephrine （H, n = 27）. The animals were anesthetized with intraperitoneal 10% chloral hydrate 350 mg·kg^-1 and tracheotomized and mechanically ventilated after Ⅳ vecuronium. PaCO2 was maintained at 35-45 mm Hg. Bilateral femoral arteries and right internal jugular vein were cannulated for BP and HR monitoring and blood sampling. Left common carotid artery was exposed for continuous blood flow monitoring. Cardiac arrest was induced by asphyxia in group Ⅱ and Ⅲ while control group was subjected to no asphyxia. CPR was started at 10 min of cardiac arrest and epinephrine 20μg·100 g^- 1 or 2μg·100 g^- 1 was given via femoral artery. Blood samples were taken from femoral artery and jugular vein at 30, 60 and 120 min after restoration of spontaneous circulation （ROSC） for blood gas analysis. C（a-jv）O2 and CEO2 were calculated. Results There was no significant difference in the success rate of CPR between group Ⅱ （S） and group Ⅲ （H）. The interval between the beginning of CPR to ROSC was significantly shorter in group Ⅲ （H） than in group Ⅱ （S） （P 〈 0.05）. The blood flow through the carotid artery in group S and H was significantly increased at 5 min after ROSC as compared to the baseline values then was significantly decreased starting from 15 min after ROSC. CEO2 and C （a-jr）O2 were significantly increased after ROSC as compared to the baseline values in group H and S but were significantly lower in group H than in group S. Conclusion High-dose epinephrine administered during CPR decreases cerebral extraction of oxygen as compared to the standard-dose.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2006年第7期649-651,共3页
Chinese Journal of Anesthesiology
关键词
心肺复苏术
肾上腺素
氧耗量
脑
Cardiopulmonary resuscitation
Epinephrine
Oxygen consumption
Brain
