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Objective:To investigate changes in arterial acid-base and electrolytes after repeated episodes of ventricular fibrillation (VF) and defibrillation in a swine model.Methods:Sixteen Peking white swine, weighting (32±2.5) kg, were placed with temporary pacemaker electrodes via the left femoral vein into the right ventricle after anesthesia. Then VF was electrically induced by using a programmed electrical stimulation instrument. An arterial cannula was inserted into the left femoral artery to measure mean arterial blood pressure and cardiac output using a PiCCO monitor, with blood samples collected. The pigs were randomly divided into two group: the manual defibrillation group (MD, n=8) and the automated external defibrillation group (AED, n=8). The first defibrillation was attempted with the manufacturer’s dose (150 J) for 15 s after the successful induction of VF in the MD group. If spontaneous circulation was not recovered, 2-min chest compression and subsequent defibrillation (200 J) were attempted. For the AED group, the defibrillation was delivered following voice prompts of the AED. After the return of spontaneous circulation, the pig was allowed to stabilize for 30 min, followed by the induction of the next episode of VF. The above process was repeated five times. Arterial blood gas, cardiac biomarkers, and hemodynamic variables were measured at 30 min after the return of spontaneous circulation. Results:All pigs were successfully induced VF five times and defibrillated successfully. There were no significant changes in heart rate and mean arterial blood pressure between the two groups after repeated episodes of VF and defibrillation. Compared with baseline measurements, cardiac output tended to decrease after repeated episodes of VF and defibrillation but was not statistically significant (all P>0.05). There were no significant differences in arterial pH, HCO 3-, sodium, and lactic acid in the two groups between each measurement time point and baseline values after repeated VF (all P>0.05), but potassium levels in the two groups decreased with time, and the difference was statistically significant compared with the baseline measurement (all P<0.05). There were no significant differences in myoglobin, creatine kinase isoenzyme-MB, and cardiac troponin I for the two groups compared with baseline values after repeated episodes of VF and defibrillation or various episodes of VF between the two groups (all P > 0.05). Conclusions:Repeated episodes of VF and defibrillation have no significant effect on pH balance, but significantly decrease blood potassium. Clinical approaches (MD vs. AED) do not affect defibrillation effect, with no significant differences in hemodynamic variables and myocardial injuries.
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Objective:To investigate the clinical characteristics and risk factors of acute ischemic stroke (AIS) complicated with cerebral cardiac syndrome (CCS).Methods:The clinical data of AIS patients admitted to the ICU of our hospital from January 2019 to May 2021 were collected and retrospectively analyzed. According to whether CCS occured after stroke, the patients were divided into the CCS group and control group. Binary logistic regression analysis was used to analyze the clinical characteristics of AIS combined with CCS and the risk factors for the occurrence of CCS.Results:A total of 196 patients with AIS were included, and 92 patients had CCS, of which 74 occurred within 72 h after AIS. Binary logistic regression analysis showed that old age ( OR=1.15, 95% CI: 1.01-1.23), hypertension ( OR=1.41, 95% CI: 1.26-1.58), diabetes ( OR=2.05, 95% CI: 1.86-2.24), chronic kidney disease ( OR=1.36, 95% CI: 1.22-1.48), chronic obstructive pulmonary disease ( OR=1.46, 95% CI:1.22-2.48), smoking ( OR=1.52, 95% CI:1.23-1.78), higher NISSH score ( OR=1.36, 95% CI: 1.29-1.48), brainstem infarction ( OR=2.33, 95% CI: 2.21-2.50), thalamic infarction ( OR=1.21, 95% CI: 1.17-1.28), and hyperlipidemia ( OR=1.86, 95% CI: 1.61-1.96) were associated with the occurrence of CCS after stroke. Conclusions:CCS is a common complication in patients with AIS, and mostly occurs within 72 hours after stroke. The risk of CCS is not only related to the history of hypertension, diabetes, chronic kidney disease, smoking history and hyperlipidemia, but also related to the location of infarction and the degree of nerve function injury. The changes of cardiac function in patients with AIS should be closely monitored to prevent cardiac events.
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Objective:To explore the efficacy of Matas test combined with endovascular intervention on patients with traumatic internal carotid-cavernous fistula.Methods:A retrospective case study was performed on 144 patients with traumatic internal carotid-cavernous fistula treated in our department from August 2012 to June 2018. The clinical symptoms, intraocular pressure and visual acuity data before and after surgery were counted, and the paired t test was used for statistical analysis. Logistic regression was performed to analyze factors affecting recurrence.Results:The main symptoms of traumatic internal carotid-cavernous fistula were proptosis, bulbar conjunctival hyperemia and cranial sound. Postoperative intraocular pressure was significantly lower than preoperative intraocular pressure [(11.13±2.97) mmHg vs. (22.37±6.64) mmHg] and postoperative visual acuity was significantly higher than preoperative visual acuity [(0.69±0.36) vs. (0.47±0.25)] and (both P<0.05). Postoperative intraocular pressure was an independent risk factor for recurrence within 3 months ( OR=0.357, 95% CI: 0.135-0.944, P=0.037), and the recurrence rate was 10.42%. Conclusions:Matas test combined with endovascular intervention in the treatment of traumatic internal carotid-cavernous fistula can effectively reduce intraocular pressure, improve visual acuity, and has a definite curative effect. It is one of the effective treatment methods for traumatic internal carotid-cavernous fistula.