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首页> 外文期刊>Resuscitation. >Microvascular blood flow during cardiopulmonary resuscitation is predictive of outcome.
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Microvascular blood flow during cardiopulmonary resuscitation is predictive of outcome.

机译：心肺复苏过程中的微血管血流可预测结局。

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There is growing evidence that microcirculatory blood flow is the ultimate determinant of the outcome in circulatory shock states. We therefore examined changes in the microcirculation accompanying the most severe form of circulatory failure, namely cardiac arrest and the effects of subsequent cardiopulmonary resuscitation. Ventricular fibrillation was electrically induced in nine pigs and untreated for 5min prior to beginning closed chest cardiac compression and attempting electrical defibrillation. Orthogonal polarization spectral imaging was utilized for visualization of the sublingual microcirculation at baseline, 0.5, 1, 3 and 5min after onset of ventricular fibrillation and at 1 and 5min after start of chest compression. Images were also obtained 1 and 5min after restoration of spontaneous circulation. Microvascular flow was graded from 0 (no flow) to 3 (normal flow). Aortic and right atrial pressures were measured and coronary perfusion pressure was computed continuously. Microcirculatory blood flow decreased to less than one-fourth within 0.5min after inducing ventricular fibrillation. Precordial compression partially restored microvascular flow in each animal. In animals that were successfully resuscitated, microvascular flow was significantly greater after 1 and 5min of chest compression than in animals with failed resuscitation attempts. Microvascular blood flow was highly correlated with coronary perfusion pressure (r=0.82, p<0.01). Microvascular blood flow in the sublingual mucosa is therefore closely related to coronary perfusion pressure during cardiopulmonary resuscitation and both are predictive of outcome.
机译：越来越多的证据表明，微循环血流量是循环休克状态转归的最终决定因素。因此，我们研究了伴随最严重形式的循环衰竭的微循环变化，即心脏骤停和随后的心肺复苏的影响。在开始闭合胸腔心脏按压并尝试电除颤之前，在9头猪中诱发了心室纤颤，未治疗5分钟。正交极化光谱成像用于观察基线，室颤发作后0.5、1、3和5min以及开始胸部按压后1和5min的舌下微循环。恢复自发循环后1和5分钟也获得了图像。微血管流量从0（无流量）降至3（正常流量）。测量主动脉和右心房压力，并连续计算冠脉灌注压力。诱发心室纤颤后0.5分钟内，微循环血流量降至不足四分之一。心前区受压可部分恢复每只动物的微血管流量。在成功复苏的动物中，胸部按压1和5分钟后的微血管流量明显大于复苏尝试失败的动物。微血管血流量与冠脉灌注压高度相关（r = 0.82，p <0.01）。因此，舌下粘膜下的微血管血流量与心肺复苏过程中的冠状动脉灌注压密切相关，并且两者均预示着结果。

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