Establishment Of Minimally Invasive Tracheal Intubation Model In Rabbits And To Compare The Effect Of Cardiopulmonary Resuscitation

Background and ObjectiveCardiac arrest is the leading cause of sudden death in healthy adults and accounts for almost half of all deaths.Although there were many related studies but solved problems rarely,and out of hospital cardiac arrest(Out of hospital Cardiac Arrest,OHCA)the survival range of 2~11%.Although Arrest(In-hospital,IHCA)survival rate was higher in the hospital,but also at 15~22%.In addition,the incidence of severe neurological deficits was 30~60%,OHCA was 10~20%.Among the survivors,only 3%~7% can recover to the previous functional status of life,the rest of the quality of life with poor functioning,generally in a coma or paralysis.This situation is a serious burden on the family,health services and social medical resources.So,the cardiac respiratory arrest after cerebral resuscitation is very important.Current research suggests that the key to brain resuscitation is early brain protection.The implementation of cardiopulmonary resuscitation in hospital,clinical anesthesia and tracheal intubation is the most commonly used method for effective ventilation in resuscitation.It can make patients with hypoxia or oxygen free blood into oxygen rich blood,through the effective external pressure can be transported to all parts of the body,especially the brain,heart,lungs,kidneys and other organs.However,due to the factors such as anatomy and pathophysiology,the failure rate of intubation was 0.5% ~ 3.5%,even in the strict training of Anesthesiologists.So,even more of a challenge for all physicians.Breathing and cardiac arrest,which is the key to provide timely and effective oxygen delivery to the tissues,because brain tissue tolerance to hypoxia is the worst.Stop the heart after 10 s,the oxygen will exhaustion for brain,and approximately 5 mins the ATP in brain cells will be depleted.In order to achieve effective oxygen supply,open the airway and maintain airway patency is the most effective measure,that is the BLS(basic life surport).In the process of cardiopulmonary resuscitation,we should open the airway to ensure smooth airway,and timely recovery of effective ventilation is the key to successful rescue.There are few studies on the tracheal intubation in different ways for cardiopulmonary resuscitation and prognosis.This paper used directly after anesthesia and tracheal intubation,anesthesia after incision and retrograde tracheal intubation and anesthesia after percutaneous retrograde intubation of rabbit cardiac arrest model as the research object.To observe the changes of arterial blood pressure,syndrome incidence and survival time after resuscitation.But the existing tracheal intubation trauma has greater damage,and difficult for airway management.After the recovery of the animal survival time is short,in view of this,we modified the original model in tracheal intubation on the basis.To explore the establishment of a more consistent with the clinical practice of tracheal intubation after cardiac arrest syndrome for animal model.AimTo establish a method of tracheal intubation with little injury,and compare the effect on the cardiopulmonary resuscitation.Improve the quality of post cardiac arrest syndrome model and establish a solid foundation for brain resuscitation.Material and methodsThirty rabbits were divided into 3 groups of 10 rabbits each according to the random number table: group A minimally invasive endotracheal intubation after anesthesia,group B separation of cervical tissue and retrograde tracheal intubation after anesthesia and group C percutaneous retrograde tracheal intubation after anesthesia.After the intravenous injection of forskolin,cardiac arrest was induced by endotracheal tube clamping.After 5 minutes of untreated arrest,conventional cardiopulmonary resuscitation was initiated.Changes in arterial pressure,occurrence of post-resuscition syndrome and survival time were examined in all groups.ResultsGroups A,B and C showed 50%,60%and 80%success rate in cardiopulmonary resuscitation(P<0.01)animal survival time of 23.4 hours(11.6~35.8 hours),62.7 hours(29.4~88.6 hours)and 79.5 hours(40.9~118.2 hours)(P<0.01).ConclusionMinimally invasive endotracheal intubation is suitable to increase cardiopulmonary resuscitation rate and survival rate in rabbits with post-cardiac arrest,and the model is stable and reproducible.It can be used as an animal model of cardiac arrest,provide a reliable animal model for cerebral resuscitation.