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在心跳骤停和心肺复苏(CPR)中,由于细胞内有效氧降低而发生无氧代谢和乳酸性酸中毒(LA)。pH值的降低可抑制心肌功能故需矫正。其机理可能是钙的利用降低或结合型钙蛋白减少或心肌功能下降和对儿茶酚胺类反应性降低。就其自然缓冲力而论,用NaHCO_3可达此目的。但是,用NaHCO_3常效果不佳。据报告NaHCO_3对正常狗可改变冠状动脉血液动力学和代谢,而对人类则可减少心肌利用氧而导致心肌缺血。有人在缺氧性LA模型中使用NaHCO_3,其结果降低心输出量和血压而使血乳酸增加。这是因为NaHCO_3可直接转化为CO_2並迅速进入细胞内引起LA,最近发
In cardiac arrest and cardiopulmonary resuscitation (CPR), anaerobic metabolism and lactic acidosis (LA) occur due to the reduction of available intracellular oxygen. Decreased pH value can inhibit myocardial function so need to be corrected. The mechanism may be reduced calcium utilization or reduced binding calculus or decreased cardiac function and decreased reactivity to catecholamines. In terms of its natural damping force, NaHCO_3 is used for this purpose. However, the usual effect with NaHCO 3 is not good. It has been reported that NaHCO 3 can alter coronary hemodynamics and metabolism in normal dogs, whereas in humans, myocardial ischemia can be reduced using oxygen. Some people use NaHCO_3 in the hypoxic LA model, which results in decreased cardiac output and blood pressure and increased blood lactate. This is because NaHCO_3 can be directly converted to CO_2 and quickly enter the cell to cause LA, the most recent