Effects of interrupted abdominal aorta compression on cardiopulmonary cerebral resuscitation after cardiac arrest in rabbit / 中华危重病急救医学

ABSTRACT

Objective To explore the effect of the interrupted abdominal aorta compression after cardiopulmonary resuscitation (IAAC-CPR)on cardiopulmonary cerebral resuscitation in a rabbit model of cardiac arrest (CA). Methods According to the random number table,10 New Zealand rabbits of both genders were equally divided into the chest compression-cardiopulmonary resuscitation (CC-CPR) group or IAAC-CPR group ,with 5 rabbits in each group. CA model was reproduced by injection of iced-potassium chloride into the jugular vein and obstruction of trachea to produce asphyxia. CA was maintained for 3 minutes before cardiopulmonary resuscitation (CPR). CC-CPR was performed with assisted ventilation+chest compression,while IAAC-CPR was performed by the way of assisted ventilation + chest compressions + compressions on abdominal aorta. The hemodynamics and cerebral cortex blood flow were observed during resuscitation. Time of return of spontaneous circulation (ROSC),24-hour survival rates,and scores of neurological function,and situation of abdominal organs were recorded. Results At 30, 60,90 and 120 seconds after CPR,the cerebral blood flow (CBF,PU value)and mean arterial pressure(MAP, mmHg,1 mmHg=0.133 kPa)of IAAC-CPR group were significantly higher than those of CC-CPR group(CBF 30 seconds16.1±6.0 vs. 7.8±2.2,60 seconds91.6±11.8 vs. 57.3±23.2,90 seconds259.9±74.9 vs. 163.6± 50.3,120 seconds301.5 ±60.5 vs. 208.4 ±23.8;MAP 30 seconds46.4 ±9.4 vs. 31.4 ±8.7,60 seconds55.8 ± 13.8 vs. 34.0±11.5,90 seconds61.2±11.5 vs. 38.2±10.1,120 seconds63.6±11.8 vs. 40.2±10.2,all P<0.05). Compared with CC-CPR group,in IAAC - CPR group,the time necessary for ROSC was obviously shortened (seconds182.0 ±59.0 vs. 312.6 ±86.6,t=2.787,P=0.024),24-hour nerve function score was significantly lowered(2.4±1.7 vs. 4.6±0.6,t=2.974,P=0.023). The successful recovery rate(80.0%vs. 60.0%,χ2=0.000, P =1.000)and 24-hour survival rate (80.0% vs. 40.0%,χ2=0.417,P =0.519)were significantly increased,but without statistical significance. No liver damage was found at 24 hours after ROSC. Conclusion In the early recovery of CA in rabbit,IAAC-CPR can result in better cerebral blood flow perfusion as compared with CC-CPR,and it significantly reduced damage to the nervous system function without producing abdominal organ damage.