科研之友
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摘要
Background: Early outcome predictors after delivery room cardiopulmonary resuscitation (CPR) of asphyxiated new-borns are needed. Objectives: To investigate if cerebral (rScO(2)) and renal (rSrO(2)) tissue oxygen saturation 30 min after return of spontaneous circulation (ROSC) are different between surviving versus nonsurviving piglets with asphyxia-induced cardiac arrest and CPR. Further, to investigate the relationship of rScO(2) and rSrO(2) to cardiac output (CO), blood pressure (BP), and biochemical variables 30 min and 4 h after ROSC. Methods: Anesthetized, mechanically ventilated piglets (1-3 days, 1.7-2.4 kg) were used. rScO(2), rSrO(2), SpO(2), right common carotid artery flow, and arterial BP were measured continuously. CO was measured with echocardiography. The piglets were asphyxiated until cardiac arrest and resuscitated. Piglets that survived 4 h after ROSC (n = 12) were compared with piglets that died before planned euthanasia at 4 h (n = 13). Left ventricular, and kidney and brain tissue lactate were analyzed. Correlations between variables were assessed. Results: Thirty minutes after ROSC, median rSrO(2) (43% [n = 10] vs. 25% [n = 2], p = 0.003) but not rScO(2) (46% [41-55] [n = 10] vs. 40% [22-45] [n = 5], p = 0.08) was higher in survivors than in nonsurvivors. Arterial lactate was negatively correlated and pH positively correlated with rScO(2) and rSrO(2). Left ventricular, but not kidney or brain lactate was negatively correlated with rScO(2) and rSrO(2). There was no correlation between CO or BP and rScO(2) or rSrO(2). Conclusions: Despite satisfactory CO and BP vital organ oxygenation can be poor. Tissue oxygen saturation, pH, and lactate, as measures of anaerobic metabolism, may reflect vital organ oxygenation and outcome.
- 出版日期2017
