| Objective:To compare ultrasonic signs and PICCO findings of lung injury after cardiopulmonary resuscitation in rabbit model of ventricular fibrillation.Method:A standard cardiopulmonary resuscitation (CPR) was performed in 40 healthy New Zealand rabbits using electrical stimulation induced ventricular fibrillation, until the rabbits were restored to the autonomic circulation. Rabbits were given ECG monitoring based on conventional fluid infusion, using pulse indicator continuous cardiac output (PICCO) monitoring before modeling (baseline), immediately after the restoration of spontaneous circulation (TO), ROSC 15min (T1), ROSC 30min (T2),ROSC 60min (T3) and ROSC 120min (T4) when the heart rate (HR), mean arterial pressure (MAP), extravascular lung water index (EVLWI), pulmonary vascular permeability index (PVPI), and the use of ultrasound to monitor the lung at different time points B line number, the damage to the lungs and lung ultrasound score, rabbit arterial blood extraction, determination at each time point using the blood gas analyzer oxygen partial pressure (Pa02), pH index, calculated the oxygenation index(Pa02/FiO2). In the model, before making the return of spontaneous circulation immediately, 2 hours after ROSC respectively for lung biopsy from rabbit lung tissue using hematoxylin eosin (HE) staining method was used to observe the pathological changes of lung tissues, and pathological lung injury score of lung tissue, finally to death at the end of the experiment in rabbits.Result:(1)The model of ventricular fibrillation and cardiac arrest in 40 rabbits was successfully performed. During the experiment, 8 rabbits died, and more than 32 rabbits recovered from cardiopulmonary resuscitation and survived to the end of the experiment. After the recovery of the autonomic circulation (ROSC), both HR and MAP increased at each time point, and the differences were statistically significant(P<0.05).(2)Compared with the previous model, the restoration of spontaneous circulation at each time point after EVLWI continued to rise, compared with the model before the difference was statistically significant (P<0.05),120 minutes after recovery of spontaneous circulation in the most obvious (P<0.05), spontaneous circulation recovery at each time point after PVPI than before modeling the rise, there was statistical significance the difference (P<0.05).(3)Lung monitoring, B line count, the recovery of autonomic circulation after each time point compared with the basic value increased significantly, the difference was statistically significant (P<0.05).(4)Compared with the model before, the P/F decreased significantly after the recovery of the autonomic circulation (P<0.05), and could be judged by the histopathological findings and the scores of the two lung injuries.(5) The EVLWI and B line count at the level of P=0.01 was significantly correlated to the value after the restoration of spontaneous circulation (r=0.872,P=0.000); and the changes in the number of spontaneous circulation recovery after the Blue B line (B line) and EVLWI (EVLWI) showed a significant correlation between the change of (r=0.719, P= 0).(6) Testoration of spontaneous circulation after each point of the B line and the oxygenation index was negatively correlated (r=-0.590, P=0.001); return of spontaneous circulation after each point of the B line and the corresponding lung injury of lung tissue was positively correlated (r=0.985, P=0.000). The correlation between lung ultrasound lung injury score and lung pathological score at each time after recovery of autonomic circulation was analyzed, and it was found that the two had significant positive correlation (r=0.993, P=0.000).Conclusion:(1) All the rabbits suffered from lung injury, mainly interstitial lung injury,which showed that lung injury was common after cardiac arrest, and may occur in the early stage of recovery.(2) Compared with PICCO, lung ultrasound as a noninvasive monitoring method can be used to monitor acute lung injury in the early stage of cardiac arrest. |
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