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目的 :研究胸外按压下血液循环时间 ,探讨临床心肺复苏过程血管活性药物用药间隔时间。方法 :对ICU病房和急诊抢救的危重病人 12例 ,行有创的动脉压监测或Swan -Ganz导管血流通动力学监测和呼吸支持。在标准的心肺复苏 (CPR) 30～ 90min后病人仍无成活可能者 ;11例病人进行胸外心脏按压循环支持方法 ,按压频率 90～ 140次 /分 ;1例有自主循环与复苏时对比结果 ;1例为开胸心脏按压。从所选取的部位 (踝静脉 ,足背动脉 ,股静脉 )注入 740MBO (TcO4 -锝淋液 ) 2mL ,从所测部位 (右心房 ,股动脉 ,桡动脉 ,足背动脉 )连续抽取血标本 15份 ,每份标本是在 15s内缓慢抽血 2mL ,测量诸份标本放射性含量 ,以时间 -放射剂量曲线计算各间隔的血液循环时间。结果 :在胸外按压循环支持下 ,心排量为 1 81± 0 6 5升 /分 (n =10 )时 ,血液循环时间为 :股静脉 -右房为38 7± 9 9s(n =6 ) ;踝静脉 -右房 (推注 )为 2 2 5± 7 8s (n =7) ;足背动脉 -右房为 74 7± 7 5s (n =3) ;右房 -股动脉为 6 4 3± 14 2s(n =7) ;右房 -足背动脉为 92 7± 30 6s(n =3) ;足背动脉 -足背动脉为 170 5± 31 0s (n =4)。结论 :在胸外按压下 ,血液做 1次周身循环的时间在 3min左右 ;从外周静脉到右心房的血液循环的时间为0 5～ 1min ,?
OBJECTIVE: To study the blood circulation time under chest compressions and to discuss the interval of medication of vasoactive drugs during clinical cardiopulmonary resuscitation. Methods: 12 critically ill patients in ICU ward and emergency department were treated with invasive arterial pressure monitoring or Swan-Ganz catheter blood flow dynamics monitoring and respiratory support. In the standard CPR 30 ~ 90min after the patient is still no possibility of survival; 11 patients with intra-thoracic cardiac compression circulation support method, the press frequency of 90 to 140 beats / min; 1 case of spontaneous circulation and recovery of the comparison results ; 1 case of heart thoracotomy. Two mL of 740 MBO (TcO4-TcL) was injected from selected sites (ankle, dorsalis, femoral) and blood samples were continuously drawn from the site of measurement (right atrium, femoral artery, radial artery, dorsalis pedis artery) Each sample was slowly drawn blood 2mL within 15s, measured the radioactive content of various specimens, time-dose curve to calculate the interval of blood circulation time. Results: The blood circulation time was 38 7 ± 9 9 s (n = 6) when the cardiac output was 1 81 ± 0 65 l / min (n = 10) ); Ankle-right atrium (bolus) was 225 ± 7 8s (n = 7); the dorsalis pedis-right atrium was 74 7 ± 7 5s (n = 3) 3 ± 14 2s (n = 7). The right atrium-dorsal artery was 92 7 ± 30 6s (n = 3), while the dorsalis pedis-dorsalis artery was 170 5 ± 31 0s (n = 4). Conclusion: Under chest compressions, the blood circulation time is about 3min; the time from the peripheral vein to the right atrium is 0 ~ 5min,