EFFECTS OF VAGAL TONE ON RESUSCITATION FROM EXPERIMENTAL ELECTROMECHANICAL DISSOCIATION

被引：13

作者：

DEBEHNKE, DJ

机构：

[1] Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee

来源：

ANNALS OF EMERGENCY MEDICINE | 1993年 / 22卷 / 12期

关键词：

ELECTROMECHANICAL DISSOCIATION; PARASYMPATHETIC NERVOUS SYSTEM;

D O I：

10.1016/S0196-0644(05)80401-9

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: To determine if complete loss of vagal tone improves the return of spontaneous circulation rate in a canine model of electromechanical dissociation cardiac arrest. Design: Prospective, controlled laboratory investigation using an asphyxial canine cardiac arrest model randomized to receive bilateral cervical vagotomy or no vagotomy. Interventions: After the production of asphyxial electromechanical dissociation arrest, 16 mongrel dogs remained in untreated electromechanical dissociation for ten minutes and then were randomized to receive bilateral cervical vagotomy or no vagotomy. All animals received standard external CPR and epinephrine (0.02 mg/kg every five minutes) throughout resuscitation. Measurements and main results: Return of spontaneous circulation was achieved in 13% (one of eight) of no vagotomy and 75% (six of eight) of vagotomy animals (P = .02). Survival to one hour was achieved in 100% (one of one) of no vagotomy and 83% (five of six) of vagotomy animals (P = NS). The hemodynamic and arterial blood gas values at five, ten, and 15 minutes into resuscitation were not significantly different between groups. Conclusion: In this canine model of asphyxial electromechanical dissociation cardiac arrest, surgical vagotomy and complete loss of vagal tone improved the rate of return of spontaneous circulation.

引用

页码：1789 / 1794

页数：6

共 16 条

[1] Edgren, Jeklsey, Sutton, Et al., The presenting ECG pattern in survivors of cardiac arrest and its relation to the subsequent long-term survival, Acta Anaesthesiol Scand, 33, pp. 265-271, (1989)
[2] Vanags, Thakur, Stueven, Et al., Interventions in the therapy of electromechanical dissociation, Resuscitation, 17, pp. 163-171, (1989)
[3] Stueven, Aufderheide, Waite, Et al., Electromechanical dissociation: Six years prehospital experience, Resuscitation, 17, pp. 173-182, (1989)
[4] Stueven, Waite, Troiano, Et al., Prehospital cardiac arrest—A critical analysis of factors affecting survival, Resuscitation, 17, pp. 251-259, (1989)
[5] Sutton-Tyrrell, Abramson, Safar, Et al., Predictors of electromechanical dissociation during cardiac arrest, Annals of Emergency Medicine, 17, pp. 572-575, (1988)
[6] Vincent, Thijs, Weil, Et al., Clinical and experimental studies on electromechanical dissociation, Circulation, 64, pp. 18-27, (1981)
[7] Brown, Lewis, Criley, Et al., Asystole and its treatment: The possible role of the parasympathetic nervous system in cardiac arrest, JACEP, 8, pp. 448-452, (1979)
[8] Aufderheide, Thakur, Stueven, Et al., Electrocardiographic characteristics in EMD, Resuscitation, 17, pp. 183-193, (1989)
[9] Emergency Cardiac Care Committee and Subcommittees, American Heart Association, Guidelines for cardiopulmonary resuscitation and emergency cardiac care III Adult advanced cardiac life support, JAMA: The Journal of the American Medical Association, 268, pp. 2199-2241, (1992)
[10] Chamberlain, Turner, Sneddon, Effects of atropine on heart rate in healthy man, Lancet, 2, pp. 12-15, (1967)

← 1 2 →