正常血容量和低血容量心脏骤停猪模型的骨内和静脉注射肾上腺素。

Denise Beaumont, Michelle Johnson, Julie G Hensler, Dawn Blouin, Joseph O'Sullivan, Don Johnson
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引用次数: 0

摘要

目的:本研究的目的是比较在低血容量和等血容量心脏骤停模型中使用肾上腺素时,曲线下面积(AUC)、频率和自发循环恢复(ROSC)的几率。方法:28头成年猪随机分为4组:HIO低容量组(HIONG);低血容量组(HIOHG);IV等容血症;静脉低血容量组(IVHG)。猪被麻醉了。HIOH和IVH受试者的血容量为35%。两人都被逮捕。2分钟后,开始心肺复苏。2分钟后,静脉滴注肾上腺素1 mg;在5分钟内采集血样,用高效液相色谱法进行分析。受试者每2分钟除颤一次。结果:HIOHG组的AUC明显小于HIONG组(p = 0.047)和IVHG组(p = 0.021)。各组间AUC差异无统计学意义(p > 0.05)。HIONG组ROSC发生率明显高于HIOHG组(p =0.018)和IVH组(p =0.018),其他差异无统计学意义(p > 0.05)。HIONG发生ROSC的几率是HIOHG的19.2倍。结论:本研究有力地支持了HIO给药肾上腺素的有效性,对于因等容性原因引起的心脏骤停患者应考虑将其作为一线干预措施。然而,我们的研究结果不支持对低血容量原因引起的心脏骤停患者使用HIO通道给药。
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Humerus Intraosseous and Intravenous Administration of Epinephrine in Normovolemic and Hypovolemic Cardiac Arrest Porcine Models.

Objective: The aim of this study was to compare area under the curve (AUC), frequency, and odds of return of spontaneous circulation (ROSC) when epinephrine was administered in hypovolemic and normovolemic cardiac arrest models.

Methods: Twenty-eight adult swine were randomly assigned to 4 groups: HIO Normovolemia Group (HIONG); HIO Hypovolemia Group (HIOHG); IV Normovolemia (IVNG); and IV Hypovolemia Group (IVHG). Swine were anesthetized. The HIOH and IVH subjects were exsanguinated 35% of their blood volume. Each was placed into arrest. After 2 minutes, cardiopulmonary resuscitation was initiated. After another 2 minutes, 1 mg of epinephrine was given by IV or HIO routes; blood samples were collected over 5 minutes and analyzed by high-performance liquid chromatography. Subjects were defibrillated every 2 minutes.

Results: The AUC in the HIOHG was significantly less than both the HIONG (p = 0.047) and IVHG (p = 0.021). There were no other significant differences in the groups relative to AUC (p > 0.05). HIONG had a significantly higher occurrence of ROSC compared to HIOHG (p = 0.018) and IVH (p =0.018) but no other significant differences (p > 0.05). The odds of ROSC were 19.2 times greater for HIONG compared to the HIOHG.

Conclusion: The study strongly supports the effectiveness of HIO administration of epinephrine and should be considered as a first-line intervention for patients in cardiac arrest related to normovolemic causes. However, our findings do not support using HIO access for epinephrine administration for patients in cardiac arrest related to hypovolemic reasons.

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