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題名 | Cardiac Arrest Induced by Accidental Inhalation of Anoxic Gases, Is the Cause Always a Lack of Oxygen?=意外吸入不含氧氣的氣體所起的心臟停止其機轉是否與氧氣有關 |
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作者 | 姚文聲; 李汝浩; | 書刊名 | 長庚醫學 |
卷期 | 23:6 2000.06[民89.06] |
頁次 | 頁331-338 |
分類號 | 416.5 |
關鍵詞 | 心臟; 停止; 急性無氧; 100%二氧化碳; 100%笑氣; Heart; Arrest; Acute anoxia; 100% CO[feaf]; 100% N[feaf]O; |
語文 | 英文(English) |
英文摘要 | Background. We experienced a case of accidental administration of 100% carbon dioxede (CO2) during anesthesia, which resulted in cardiac arrest. After successful cardio-pulmonary resuscitation the child recovered without brain damage. This outcome was quite different than that of the more commonly reported accidental administration of 100% nituous oxede (N2O), as the latter usually results in death from cerebral damage rather than cardiac arrest. We speculated that the cause of death and/or cardiac arrest may differ between these two anoxic gases. Methods. Fourteen dogs were anesthetized and divided into two groups to receive either100% CO2 or 100% N2O. Blood pressure (BP), heart rate (HR), cardiac output (CO), dp/dt, pulmonary artery pressure (PAP), central venous pressure (CVP) and blood gases (BG) were measured every 30 seconds until cardiac arrest (CA) occurred. Results. The CO2 group showed a rapid decline in BP, HR, dp/dt, CO, pH, and PaO2 and a rise in PAP, CVP, and PaCO2, with CA occurring at 119�41 seconds. At the time of CA, the BG values were pH 6.6�0.09, PaCO2 375�69, and PaO2 62�15 mm Hg. The N2O group maintained BP, HR, dp/dt, pH, PaCO2, and experienced a rapid decline in PaO2 as in the CO2 group until 180 seconds, at which time the PaO2 was 12.3�3 mm Hg. CA occurred at 390�52 seconds. The values for pH, PaCO2 and PaO2 were 7.5�0.05, 25�15 and 4.8�1 mm Hg, respectively, at the time of CA. Conclusion. One hundred percent CO2-induced cardiac arrest occurred in 119 seconds and was not oxygen-dependent, whereas 100% N2O induced cardiac arrest occurrred in 390 seconds and was clearly dependent on hypoxemia. |
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