Comparison of various cardiopulmonary resuscitation(CPR) techniques evaluated by internal jugular venous oxygen saturation.
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概要
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To evaluate the cerebral blood flow and cerebral oxygen metabolism of the various resuscitation techniques, continuous monitoring of jugular oxygen saturation (SjO2) was carried out during various cardiopulmonary cerebral resuscitation (CPCR) procedures. Forty-four patients who were suffering from cardiopulmonary arrest in the ICU or emergency room, were continuously monitored for SjO2 just before the cardiopulmonary arrest. There were 24 males and 6 females, with a mean age of 56.3±2.1 years (range, 14-81 years). During the recording of SjO2, the level of saturation of arterial oxygen (SaO2) was maintained at over 95%. Closed chest cardiac massage (standard CPR) was carried out on only 16 of 30 patients, active compression-decompression CPR (ACD-CPR) was used for 5 patients, open chest cardiac massage for 4 patients, and percutaneous cardiopulmonary support (PCPS) for 5 patients. The level of SjO2 was 69.1±8.6% during standard CPR. During ACD-CPR, open chest cardiac massage (Open-CPR), and PCPS the levels of SjO2 were 74.8±14.1%, 75.1±10.3%, and 70.0±10.8%, respectively. These differences were not statistically significant. The systolic blood pressure of the patients receiving CPCR ranged from 56mmHg to 100mmHg. It is well known that jugular saturation demonstrates the ratio of cerebral blood flow to cerebral oxygen metabolism. If the level of SjO2 was within 60∼80% with SaO2 over 95%, the balance between cerebral blood flow and blood oxygen metabolism was maintained. During all of the CPCR procedures, the level of SjO2 was maintained between 60% and 80%. Our series suggested that the cerebral blood flow were perfused much enough to consumption of cerebral oxygen metabolism during the standard CPCR as well as ACD-CPR, closed chest massage CPR, and PCPS.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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