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首页> 外文期刊>Resuscitation. >The effects of pre-arrest heparin administration dose for cardiac arrest model using extracorporeal lung and a heart assist (ECLHA) in dogs.
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The effects of pre-arrest heparin administration dose for cardiac arrest model using extracorporeal lung and a heart assist (ECLHA) in dogs.

机译：逮捕前肝素给药剂量对体外肺和心脏辅助（ECLHA）对犬心脏骤停模型的影响。

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BACKGROUND AND PURPOSE: Clinical and experimental studies have shown that marked activation of blood coagulation occurs in cardiac arrest (CA) and cardiopulmonary resuscitation (CPR). Extracorporeal lung and heart assist (ECLHA) is applied in CA patients who cannot be rescued using conventional therapies. We hypothesized that the dose of heparin administered during the pre-arrest period would influence the outcome in a canine model of CA induced by 15 min of normothermia followed by ECLHA, which consists of heparin coating membrane lung and tubing. We therefore investigated the effects of two dose regimes of the pre-arrest heparin for this model. METHODS: Twelve mongrel female dogs were divided into two groups: a group given 200 U/kg heparin (H200, n=6) and a group given 700 U/kg heparin (H700, n=6), group during pre-arrest period. Normothermic ventricular fibrillation (VF) was induced in all dogs for 15 min, followed by 24h of ECLHA with rapidly induced mild hypothermia (33 degrees C) and 120 h of intensive care. Outcome evaluations included: (1) activated coagulation time (ACT); (2) catecholamine dose; (3) hematocrit (Hct) and platelet count; (4) survival rate; (5) neurological deficit scores (NDS); (6) postmortal macroscopic examination with the exception of the brain. RESULTS: In the H200 group, four dogs died of cardiogenic shock within 28 h. The autopsy revealed extensive patchy hemorrhages in the heart and intestine. In the H700 group, the amount of dopamine was significantly lower (6+/-10mg versus 75+/-41 mg, p<0.05) and the survival rate was significantly higher (100% versus 17%, p<0.05) than in the H200 group. The NDS at 120 h in the H700 group was 18+/-8% and the autopsy revealed an almost normal external appearance of the vital organs. There were no significant differences between groups in either the Hct and platelet count during the 24h of resuscitation, and no bleeding complications were observed. CONCLUSION: The use of ECLHA to resuscitate animals in prolonged CA may require a large dose of systemic heparin during the pre-arrest period even if ECLHA circuit was coated with heparin.
机译：背景与目的：临床和实验研究表明，在心脏骤停（CA）和心肺复苏（CPR）中发生明显的凝血激活。体外肺和心脏辅助治疗（ECLHA）用于无法使用常规疗法挽救的CA患者。我们假设在逮捕前给予的肝素剂量会影响正常温度15分钟和随后的ECLHA诱导的CA犬模型的预后，ECLHA由肝素覆盖膜肺和输液管组成。因此，我们研究了逮捕前肝素的两种剂量方案对该模型的影响。方法：将十二只杂种雌性狗分为两组：逮捕前每组给予200 U / kg肝素（H200，n = 6）和一组给予700 U / kg肝素（H700，n = 6）。 。在所有犬中诱导正常体温的心室纤颤（VF）15分钟，然后在24小时的ECLHA中快速诱导亚低温（33摄氏度）和120 h的重症监护。结果评估包括：（1）激活凝血时间（ACT）; （2）儿茶酚胺剂量; （3）血细胞比容（Hct）和血小板计数; （4）成活率; （5）神经功能缺损评分（NDS）; （6）死后肉眼检查除大脑外。结果：在H200组中，四只狗在28小时内死于心源性休克。尸检显示心脏和肠道广泛的斑块状出血。在H700组中，与多巴胺相比，多巴胺的量显着降低（6 +/- 10mg对75 +/- 41 mg，p <0.05），生存率显着更高（100％对17％，p <0.05）。 H200组。 H700组在120小时时的NDS为18 +/- 8％，尸检显示重要器官的外观几乎正常。复苏24小时内两组间Hct和血小板计数无显着差异，且未观察到出血并发症。结论：即使在ECLHA回路涂有肝素，在拘捕前期使用ECLHA复苏长时间CA的动物也可能需要大剂量的全身肝素。

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