中华医学杂志（英文版）2002，Vol.115Issue(3)：359-363,5.
心泵或胸泵,心肺复苏时经食管超声心动图的观察
Pump models assessed by transesophageal echocardiography during cardiopulmonary resuscitation
刘品明 1高燕 2傅向阳 3吕俊豪 3周瑛 3魏向龙 3李公信 3丁明学 3吴宏超 3叶文胜 3刘映峰 3李志樑3
作者信息
- 1. 中山大学附属第二医院心内科,广州,510120
- 2. 济南空军总医院内科,济南,250031
- 3. 第一军医大学珠江医院心内科,广州,510282
- 折叠
摘要
Abstract
Objective Transesophageal echocardiography was performed during closed-chest cardiopulmonary resuscitation (CPR) in in-hospital cardiac arrest to further explore the hemodynamic mechanism of CPR. Methods CPR attempts were performed according to advanced cardiovascular life support guidelines in 6 cases of in-hospital cardiac arrest. Multi-plane transesophageal echocardiography was carried out within 15 min of initiation of CPR. Throughout CPR, the motion of the mitral, tricuspid and aortic valves, the changes in the left ventricular cavity size and the thoracic aortic diameter were observed. Trans-mitral and trans-aortic Doppler files of blood flow were also documented. Results A closure of the mitral and tricuspid valves with simultaneous opening of the aortic valve occurred exclusively during chest compression, resulting in forward blood flow in the pulmonary and systemic circulation. Peak forward aortic flow at a velocity of 58.8±11.6?cm/s was recorded during the compression phase. Whereas, a closure of the aortic valve and rapid opening of the atrioventricular valves associated with ventricular filling during relaxation of chest compression was noted in all 6 patients. Peak forward mitral flow at a velocity of 60.6±20.0?cm/s was recorded during the release phase. Mitral regurgitation during the chest compression period was detected in 5 patients, reflecting a positive ventricular-to-atrial pressure gradient. A reduction in the left ventricular chamber and an increase in the thoracic aortic diameter during the compression phase was found in all patients, indicating that direct cardiac compression contributed to forward blood flow. Conclusion These observations favor the cardiac pump theory as the predominant hemodynamic mechanism of forward blood flow during CPR in human beings.关键词
心脏骤停/心肺复苏/经食管超声心动图/血液动力学Key words
cardiac arrest/cardiopulmonary resuscitation/transesophageal echocardiography/hemodynamics分类
医药卫生引用本文复制引用
刘品明,高燕,傅向阳,吕俊豪,周瑛,魏向龙,李公信,丁明学,吴宏超,叶文胜,刘映峰,李志樑..心泵或胸泵,心肺复苏时经食管超声心动图的观察[J].中华医学杂志（英文版）,2002,115(3):359-363,5.
