无血预充大鼠体外心肺复苏模型的建立及支持效果评价  

Establishment and Effect Evaluation of An Rat Model for Extracorporeal Cardiopulmonary Resuscitation without Blood Priming

作　　者：薛平菲 于洁[2] 秦春妮[2] 陈书弘 黑飞龙[2] 王寿世 刘英志 XUE Ping-fei;YU Jie;QIN Chun-ni;CHEN Shu-hong;HEI Fei-long;WANG Shou-shi;LIU Ying-zhi(Department of Anesthesiology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China;Department of Extracorporeal Circulation,State Key Laboratory of Cardiovascular disease,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100037,China;Department of Anesthesiology,Qingdao Central Hospital,Qingdao 266041,China)

机构地区：[1]青岛大学医学部青岛大学附属医院麻醉科,青岛市266003 [2]中国医学科学院北京协和医学院国家心血管病中心心血管疾病国家重点实验室阜外医院体外循环中心,北京市100037 [3]青岛大学医学部青岛市中心医院麻醉科,青岛市266041

出　　处：《中国分子心脏病学杂志》2021年第1期3748-3752,共5页Molecular Cardiology of China

摘　　要：目的建立稳健的大鼠体外心肺复苏(ECPR)模型,为体外生命支持研究的发展提供思路。方法12只成年雄性SD大鼠,随机分成常规心肺复苏(CCPR)组及体外心肺复苏(ECPR)组,各6只。两组均吸入七氟烷诱导麻醉,行气管切开术置入自制气管插管,经右股动脉监测血流动力学。C组仅行常规心肺复苏治疗,E组建立V-A ECMO,CA后行ECMO辅助下心肺复苏,大鼠复苏成功后继续观察90min。两组均持续监测呼吸、血流动力学,并于窒息前、复苏后30min行血气分析。实验结束后均给予过量麻醉处死大鼠并取材。结果12只大鼠中11只建模成功,E组均成功ROSC,血流动力学稳定,血气结果良好;C组5只成功ROSC,1只抢救失败死亡,余循环稳定。两组大鼠的体重、窒息前的肛温、MAP、心率、窒息法致CA时间、CA持续时间等基线资料进行比较,差异均无统计学意义(均为P>0.05)。两组大鼠的心肺复苏时间的差异有统计学意义(P<0.05),复苏后血气分析与基线血气相比均变化较大,以pH及BE异常为著。另外,E组与C组相比,复苏后血气分析中pH、BE、PO2、Hct及Hb的差异均有统计学意义(P<0.05);其中,E组的Hct、Hb明显下降(P<0.001)。结论本实验成功建立了无血预充大鼠ECPR模型,ECPR组改善组织灌注的疗效优于CCPR组。Objective The purpose of this study was to establish an extracorporeal cardiopulmonary resuscitation model in rats and assess the efficacy.Methods Twelve healthy male SD rats were randomly divided into a conventional cardiopulmonary resuscitation(CCPR)group and an extracorporeal cardiopulmonary resuscitation(ECPR)group,each with 6 rats.All rats were anesthetized by inhalation of sevoflurane and inserted a self-made tracheal intubation after tracheotomy.Group C received conventional cardiopulmonary resuscitation and group E followed by extracorporeal cardiopulmonary resuscitation.Both groups were monitored for respiration,mean arterial pressure,heart rate and blood gas analysis.After the experiment,the rats were killed by overdose anesthesia.Results The rats in group E all succeeded in ROSC,breathing and circulation were stable;5 rats in group C succeeded in ROSC,one died after rescue failure.There were no statistically significant differences in the baseline data of the two groups of rats,such as body weight,rectal temperature,mean arterial pressure,heart rate,asphyxia to cardiac arrest time,and cardiac arrest duration(all P>0.05).The difference in cardiopulmonary resuscitation time between the two groups was statistically significant(P<0.05).The blood gas analysis after CA changed significantly in pH and BE compared with baseline.In addition,the differences were statistically significant between the two groups in the items of pH,BE,PO2,Hct,and Hb in the blood gas analysis after CA(P<0.001).Conclusion This experiment successfully established an ECPR model in rats without blood priming,which can effectively improve tissue perfusion compared with the CCPR group.

关 键 词：体外膜肺氧合 体外心肺复苏 大鼠 动物模型 

分 类 号：R459.7[医药卫生—急诊医学] R-332[医药卫生—治疗学]