Original Articles Korean Circulation J 1999;2910:1105-1111 심정지동물모델에서이중혈류유발심폐소생술과 표준심폐소생술의혈역학적효과비교 황성오 1 조준휘 1 오범진 1 강구현 1 김성환 1 문중범 1 이서영 1 박해상 1 이강현 1 이승환 2 윤정한 2 최경훈 2 이윤선 3 Hemodynamic Effects of Simultaneous Sterno-Thoracic Cardiopulmonary ResuscitationSST-CPR in Canine Model of Cardiac Arrest Sung Oh Hwang, MD 1, Jun Hwi Cho, MD 1, Bum Jin Oh, MD 1, Ku Hyun Kang, MD 1, Sung Hwan Kim, MD 1, Joong Bum Moon, MD 1, Seo Young Lee, MD 1, Hae Sang Park, MD 1, Kang Hyun Lee, MD 1, Seung Hwan Lee, MD 2, Junghan Yoon, MD 2, Kyung Hoon Choe, MD 2 and Yoon Sun Lee, MD 3 1 Department of Emergency Medicine and 2 Internal Medicine, Wonju College of Medicine and 3 Department of Biomedical Electronic Engineering, College of Health Science, Yonsei University, Wonju, Korea ABSTRACT Background and ObjectivesNo existing device for cardiopulmonary resuscitation CPR is designed to exploit both the cardiac pumpand the thoracic pumpsimultaneously. This study was designed to assess the hemodynamic effects of simultaneous sterno-thoracic CPR SST-CPR vs. standard CPR S-CPR using a mechanical resuscitator in a canine model of cardiac arrest. Device DescriptionWe have built a device that depresses the sternum and circumferentially constricts the thorax simultaneously. This device has two components. The first component is a piston, which depresses the sternum. The second is a circumferential strap that constricts the thorax as the piston is pushed down on the sternum. Materials and MethodsTwelve domestic dogs were enrolled in this study. After catheterizations to measure pressures from the aorta and the right atrium, ventricular fibrillation was induced by passing AC current to the right ventricle. After 4 minutes of cardiac arrest, S-CPR and SST-CPR were performed alternatively. Aortic pressure, right atrial pressure, cardiac output, and end tidal CO 2 were measured while each method of CPR was performing. ResultsSST-CPR resulted in significantly higher mean arterial pressure than S-CPR 68.916.1 vs 30.510.0 mmhg, p0.01. SST-CPR could generate higher coronary perfusion pressure than S-CPR 47.011.4 vs 17.38.9 mmhg, p0.01. End tidal CO 2 tension was also higher during SST-CPR than S-CPR 11.66.1 vs 2.173.3 mmhg, p0.01. ConclusionSimultaneous sternothoracic cardiopulmonary resuscitation is a new method of cardiopulmonary resuscitation, which can generate better hemodynamic effects than standard cardiopulmonary resuscitation. Korean Circulation J 1999;2910:1105-1111 KEY WORDSCardiopulmonary resuscitation Cardiac arrest. 1105
서론 대상및방법 이중혈류유발심폐소생술장치 1106 Fig. 1. Simultaneous sternothoracic cardiopulmonary resuscitation SST-CPRDuring compression systole, the strap constricts the thorax while the piston depresses the sternum. During compression diastole, the piston returns to it s original position by recoiling force of the thorax of itself. Fig. 2. Top view upperand side view lower of the device for simultaneous sternothoracic cardiopulmonary resuscitationthe device consists of two main elements. Piston A in the center is to depress the sternum. Strap B is to constrict the thorax circumferentially. Strap is attached to both sides of the piston. When the piston is pushed down, it depresses the sternum and pulls on the thoracic strap. 동물실험 Korean Circulation J 1999;2910:1105-1111
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Fig. 3. Experimental protocol. *Epiepinephrine injection, S-CPRstandard cardiopulmonary resuscitation, SST-CPRsimultaneous sternothoracic cardiopulmonary resuscitation. 결 과 Fig. 4. Aortic pressure wave from standard cardiopulmonary resuscitation S-CPR and simultaneous sternothoracic cardiopulmonary resuscitation SST-CPR SST-CPR generated higher aortic pressure as well as a distinct pressure wave form with two peaks during the systole. Fig. 5. Aortic pressures from standard cardiopulmonary resu-scitation S-CPR and simultaneous sternothoracic cardiopulmonary resuscitation SST-CPR.*p0.01, compared with S-CPR 1108 Korean Circulation J 1999;2910:1105-1111
Fig. 6. Coronary Perfusion PressureSimultaneous sternothoracic cardiopulmonary resuscitation SST-CPR could gene-rate higher coronary perfusion pressure than standard CPR S-CPR. *p0.01, compared with S-CPR Fig. 7. End-tidal CO2Higher end tidal CO2 value was observed during simultaneous sternothoracic cardiopulmonary resuscitation SST-CPR. *p0.01, compared with S-CPR 고 이중혈류유발심폐소생술의혈류유발기전 찰 이중혈류유발심폐소생술에의한관상동맥관류압과호기말이산화탄소압 1109
새로운심폐소생술방법으로서의이중혈류유발심폐소생술 1110 연구의제한점 Korean Circulation J 1999;2910:1105-1111
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