TRANSFEMORAL BALLOON AORTIC OCCLUSION DURING OPEN CARDIOPULMONARY-RESUSCITATION IMPROVES MYOCARDIAL AND CEREBRAL BLOOD-FLOW

被引:42
作者
SPENCE, PA [1 ]
LUST, RM [1 ]
CHITWOOD, WR [1 ]
IIDA, H [1 ]
SUN, YS [1 ]
AUSTIN, EH [1 ]
机构
[1] E CAROLINA UNIV,SCH MED,DEPT PHYSIOL,GREENVILLE,NC 27858
关键词
D O I
10.1016/0022-4804(90)90122-I
中图分类号
R61 [外科手术学];
学科分类号
摘要
These experiments were designed to determine whether the limited cardiac output during open cardiac massage could be preferentially directed to the coronary and cerebral vessels by balloon occlusion of the descending thoracic aorta. Sixteen dogs were instrumented to monitor cardiac output and left atrial, right atrial, right ventricular, left ventricular, and arterial blood pressures. Measurements of myocardial and cerebral blood flow distribution during massage were made using the radioactive microsphere technique. Each animal underwent two episodes of fibrillation and resuscitation. In one episode the arrest was managed by open massage alone, and in the other, open massage was accompanied by balloon occlusion, with the order randomized. When compared to control, open cardiac massage was associated with a significant decrease in mean arterial pressure; however, the addition of balloon occlusion produced a 130% increase in the mean arterial pressure that was obtained during open CPR (control, 93 ± 5 mm Hg; massage alone, 35 ± 2 mm Hg; massage + balloon, 76 ± 2 mm Hg, P < 0.01). In a similar fashion, although the absolute blood flow was reduced by 50% when compared to control, the blood flow (ml/min/g) to the brain and heart during massage was 100% better when balloon occlusion was employed (brain: control, 0.41 ± 0.03; massage only, 0.05 ± 0.01; massage + balloon, 0.25 ± 0.02, P < 0.01; heart: control, 1.46 ± 0.11; massage alone, 0.35 ± 0.05; massage + balloon, 0.71 ± 0.05, P < 0.01). These results suggest that aortic occlusion significantly increased myocardial and cerebral perfusion patterns during ventricular fibrillation and open cardiac massage. Percutaneous transfemoral balloon aortic occlusion during CPR may be a useful adjunct to standard therapy. © 1990.
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页码:217 / 221
页数:5
相关论文
共 9 条
[1]   CORONARY BLOOD-FLOW DURING CARDIOPULMONARY RESUSCITATION IN SWINE [J].
BELLAMY, RF ;
DEGUZMAN, LR ;
PEDERSEN, DC .
CIRCULATION, 1984, 69 (01) :174-180
[2]   DETERMINANTS OF BLOOD-FLOW TO VITAL ORGANS DURING CARDIOPULMONARY-RESUSCITATION IN DOGS [J].
HALPERIN, HR ;
TSITLIK, JE ;
GUERCI, AD ;
MELLITS, ED ;
LEVIN, HR ;
SHI, AY ;
CHANDRA, N ;
WEISFELDT, ML .
CIRCULATION, 1986, 73 (03) :539-550
[3]   VEST INFLATION WITHOUT SIMULTANEOUS VENTILATION DURING CARDIAC-ARREST IN DOGS - IMPROVED SURVIVAL FROM PROLONGED CARDIOPULMONARY-RESUSCITATION [J].
HALPERIN, HR ;
GUERCI, AD ;
CHANDRA, N ;
HERSKOWITZ, A ;
TSITLIK, JE ;
NISKANEN, RA ;
WURMB, E ;
WEISFELDT, ML .
CIRCULATION, 1986, 74 (06) :1407-1415
[4]  
LUST RM, 1988, CIRCULATION, V78, P217
[5]   MECHANISMS BY WHICH EPINEPHRINE AUGMENTS CEREBRAL AND MYOCARDIAL PERFUSION DURING CARDIOPULMONARY RESUSCITATION IN DOGS [J].
MICHAEL, JR ;
GUERCI, AD ;
KOEHLER, RC ;
SHI, AY ;
TSITLIK, J ;
CHANDRA, N ;
NIEDERMEYER, E ;
ROGERS, MC ;
TRAYSTMAN, RJ ;
WEISFELDT, ML .
CIRCULATION, 1984, 69 (04) :822-835
[6]  
RUDOLPH AM, 1967, CIRC RES, V21, P136
[7]  
SUN YS, 1989, SURG FORUM, V15, P196
[8]   EXTERNAL CARDIAC COMPRESSION - RANDOMIZED COMPARISON OF MECHANICAL AND MANUAL TECHNIQUES [J].
TAYLOR, GJ ;
RUBIN, R ;
TUCKER, M ;
GREENE, HL ;
RUDIKOFF, MT ;
WEISFELDT, ML .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1978, 240 (07) :644-646
[9]  
WOLFE JA, 1988, J THORAC CARDIOV SUR, V95, P523