Correlation Study Between PiCCO And Cardiac Ultrasonography In The Early Stage Of Cardiac Arrest In A Rabbit Modle

Cardiac arrest(CA)is one of the most serious clinical manifestations.With the optimization of medical service system and the popularization of cardiopulmonary resuscitation,the return of spontaneous circulation(ROSC)has a certain improve.Early hemodynamic optimization after ROSC is one of the focuses of treatment after cardiac arrest.ROSC,the better access to hemodynamic parameters can be provided for the convenience of treatment.The clinical process of cardiac arrest is very special,clinical research by a variety of factors interfere with the establishment of reasonable scientific and simple animal model for the in-depth study of its pathophysiological process to facilitate.Pulse Indicator Continuous cardiac output(Pi CCO)monitor is a simple,minimally invasive tool for monitoring hemodynamic parameters,but as a invasive monitoring of the current cardiac arrest after the autonomic recovery The application is still subject to a number of objective factors.Bedside ultrasound in the acute critical application of the increasingly popular,by ultrasound can also be simple and quick access to some of the cardiac function-related kinetic index,access to relevant literature at home and abroad,did not find on the Pi CCO and ultrasound contrast monitoring of cardiac arrest Study on early recovery of hemodynamics by spontaneous circulation.In this study,CA model was established by chamber tremor.The early cardiac function changes were monitored by Pi CCO and cardiac ultrasonography in rabbits.Indicators of consistency and relevance.The optimal method of choice can be used to provide a reference for the hemodynamics optimization of ROSC in patients with CA.Objective The changes of cardiac function in early cardiac resuscitation were studied.The correlation between Pi CCO and cardiac ultrasound was used to evaluate the correlation.Methods Thirty healthy rabbits were used to make a cardiac arrest model.In the experiment,the changes of vital signs and electrocardiogram were observed before and after resuscitation.The recovery time of spontaneous circulation was recorded and the success rate of resuscitation was recorded.The survival rate of rabbits was recorded within 6 hours.During the basic state,when the time are t0,t1(ROSC immediate),t2(ROSC 15min),t3(ROSC 60min),t4(ROSC 120 min),t5(ROSC 6h),The data recorded by Pi CCO were as follows: Cardiac output(CO),Global end diastolic volume index(GEDVI),pulse continuous cardiac output(PCCO),peripheral(RV Vent),left ventricular anteroposterior diameter(LVd),left ventricular anteroposterior diameter(RVd),left ventricular anteroposterior diameter(RVd),left ventricular anteroposterior diameter(RVd),Left Ventricular Ejection Fractions(LVEF),Left Ventricular Ejection Fractions(LVEF).In the experiment,the relationship between the corresponding indicators,taking the pathologic specimens of HE staining,and then observed in the cardiac arrest model rabbits in the autonomic circulation to restore early cardiac pathological changes.Results 1.The model's recovery results After 30 seconds of AC stimulation,30 rabbits were induced to induce VF,but soon restored ventricular rhythm,and then to increase the AC stimulation and prolong the electrical stimulation time,the experimental rabbits were successfully induced CA,CA success rate 100%,CA induced time was 68.5 ± 9.1s,when the ECG showed VF(25,83%),PEA(3,10%),ASY(2,7%),CA continued 5min after CPR,30 rabbits,21 rabbits ECG still showed VF(21,70%),2 rabbits ECG from VF to PEA,2 from VF to ASY.After CPR,the success rate was 86.67%(26/30),and the recovery time was 210.9 ± 21.32 s in 4 rabbits(CPR,respectively).1 rabbit independent recovery after 30 min,ECG to VF,given the recovery again,the recovery was unsuccessful.Other rabbits survived to ROSC6 h,6h survival rate of 96.15%(25/26)MAP was 87.97 ± 1.34 mm Hg before modeling,70.8 ± 6.2S to 20 mm Hg,10.66 ± 3.67 mm Hg at CPR.MAP changes significantly after cardiopulmonary resuscitation,ROSC immediately 112.52 ± 16.75 mm Hg,15 min after the decline maintained at 68.21 ± 6.68 mm Hg.The heart rate(HR)was 212.76 ± 8.34/min and the ROSC was 253.16 ± 11.23/min,and then maintained at a high level.2.Results of the two monitoring methods When the tine are t0,t1,t2,t3,t4,t5,the CO measured by Pi CCO thermal dilution method was positively correlated with the CO measured by cardiac ultrasound,and positive correlation was found by pulse contour method with CO.The measured GEDVI had a high correlation with LVd,GEDVI and RVd.When the time are t0,t1,t2,t3,t4,t5,the error of CO bias between Pi CCO thermal dilution method and cardiac ultrasonography is very small,Pi CCO thermal dilution method and heart ultrasound measured the CO value is consistent;When the time are t1,t2,t3,,t5,Pi CCO pulse contour method and cardiac ultrasound measured the same effect of CO.When the time is t4,Pi CCO pulse contour method measured by the value of the value of the value of the heart ultrasound bias on the linear side of the difference,then Pi CCO pulse contour method measured by the CO and cardiac ultrasound measured CO effect is poor.3.Myocardial pathology Rabbit ventricular muscle disease in the optical microscope can be seen: myocardial fiber disorder,local necrosis occurs.Part of the cell striated disappeared,cytoplasmic red dye,and some cytoplasm can be seen vacuoles,the presence of inflammatory cell infiltration and erythrocyte exudation.Conclusion 1.Rabbit cardiac arrest after spontaneous circulation recovery 60 min after cardiac contraction ejection function decreased,the effective circulation of blood reduced.2.Cardiac ultrasound can be real-time,dynamic cardiac function monitoring,to guide the spontaneous circulation of cardiac arrest to restore early hemodynamic optimization,improve the prognosis.