Resuscitation:轻度高碳酸血症影响心脏骤停早期幸存者机械通气脑氧合

2016-02-22 MedSci MedSci原创

在心脏骤停复苏后早期行机械通气患者,采用NIRS评估,轻度高碳酸血症增加脑氧合。研究人员将进一步研究心脏骤停患者复苏后行机械通气,保持长时间轻度高碳酸血症与提高脑氧合、改善患者预后的效果。

背景

最优脑氧合被认为是心脏骤停(CA,cardiac arrest )患者脑保护的基础。高碳酸血症增加脑血流量,也可以改善脑氧合。然而,目前尚不确定是否这种效应也发生在心脏骤停后机械通气患者身上。

方法

研究纳入心脏骤停复苏后36小时内行机械通气的患者。前瞻性双交叉生理研究,使用近红外光谱(NIRS)评估区域脑组织氧饱和度(SctO2),比较血碳酸正常(PaCO2 35-45mmHg)和轻度高碳酸血症(PaCO2 45-55mmHg)对区域脑组织氧饱和度(SctO2)的影响。

结果

研究共纳入7例心脏骤停复苏后36小时内行机械通气患者,发生心脏骤停后自主循环灰度的平均时间是28分钟,行机械通气的平均时间是26.5小时。血碳酸正常组(中位数EtCO2 32 mmHg [30 - 41 mmHg] , 中位数PaCO2  37 mmHg [32 - 45 mmHg])中位数NIRS左额叶SctO2  61% [52 - 65%] ,右额叶SctO2  61% [54 - 68%]。轻度高碳酸血症组(中位数EtCO2  49mmHg [40-57mmHg] ,PaCO2 52mmHg [43-55mmHg) 左额叶SctO2增加到69% [59-78%] ,右额叶SctO2 增加到73% [61-76%](P=0.001)。

结论

在心脏骤停复苏后早期行机械通气患者,采用NIRS评估,轻度高碳酸血症增加脑氧合。研究人员将进一步研究心脏骤停患者复苏后行机械通气,保持长时间轻度高碳酸血症与提高脑氧合、改善患者预后的效果。

原始出处:

Glenn M. Eastwood, et all. Cerebral Oxygenation in Mechanically Ventilated Early Cardiac Arrest Survivors: the Impact of Hypercapnia. Resuscitation. Available online 21 February 2016.

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    2018-08-14 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

    0

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    2016-04-12 Wechat4343a314

    是吗

    0

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