Simulation of secondary cardiac arrest – the etiology of asphyxia

Autor: Korpar, Matjaž
Přispěvatelé: Križmarić, Miljenko
Jazyk: slovinština
Rok vydání: 2014
Předmět:
Zdroj: Maribor
Popis: Delni tlak ogljikovega dioksida na koncu izdiha (PetCO2) nam med oživljanjem omogoča razlikovati med primarnim in sekundarnim zastojem srca. Namen diplomskega dela je bil raziskati, ali lahko tudi na simulatorju METI HPS ločimo med obema tipoma zastoja. V Simulacijskem centru Fakultete za zdravstvene vede smo sekundarni zastoj srca simulirali kot asfiksijo povzročeno z mišičnim relaksantom in z mehanično zaporo dihalne poti. Primarni zastoj smo simulirali z aplikacijo 1 mg adrenalina. Zanimalo nas je, ali patofiziološki potek sprememb vitalnih funkcij ustreza podatkom iz literature. Simulator smo v vseh scenarijih privedli do faze zastoja srca in pričeli s predihavanjem. Spremljali smo delne tlake PetCO2, PACO2, PO2, nasičenost kisika v arterijski krvi SpO2, pH krvi, minutni iztis srca, utrip srca in krvni tlaka. Rezultati so pokazali, da obstajajo odstopanja pri primerjavi primarnega in sekundarnega zastoja srca v PetCO2. Vrednost PetCO2 je bila pri primarnem zastoju srca ob pričetku ventilacije 52 mmHg, pri sekundarnem zastoju srca zaradi zapore dihalne poti pa je bila vrednost PetCO2 bistveno višja, 85 mmHg. Vrednost pH krvi je pri vseh scenarijih padala od 7,42 do 7,34. Ob pričetku asfiksije je simulator s kompenzacijskimi mehanizmi dvigoval frekvenco utripa srca iz 72 na 151 utripov na minuto, sledila je VT s pulzom, ki se je po eni minuti spremenila v VF in po nadaljnji eni minuti v asistolijo. Minutni iztis srca je padal iz 6 L/min na 4 L/min ob pričetku VT in padel na vrednost nezdružljivo z življenjem (0,1 L/min) ob pričetku asistolije. Ugotavljamo, da simulator METI HPS ustreza predstavitvi asfiksije in je primeren za prikaz takih scenarijev v izobraževalne namene. The partial pressure of end tidal carbon dioxide (PetCO2) during resuscitation allows us to differentiate between primary and secondary cardiac arrest. The purpose of the research was to investigate whether the METI HPS simulator was able to distinguish between the two types of cardiac arrest. We conduct the study on the Simulation center of the Faculty of Health Sciences where we simulate asphyxiation caused by muscle relaxant and mechanically obstruct the airway. Primary cardiac arrest we simulated with the application of 1 mg epinephrine. We wanted to know whether the course of pathophysiological changes in vital functions corresponds to data from the literature. The simulator was in all scenarios lead to the phase of cardiac arrest and started ventilation. We monitored the partial pressure of PetCO2, PACO2, PO2, oxygen saturation in arterial blood SpO2, blood pH, cardiac output, heart rate and blood pressure. The results showed that there were differences when comparing primary and secondary cardiac arrest in PetCO2. In the primary cardiac arrest, PetCO2 was at the beginning of ventilation 52 mmHg at the secondary cardiac arrest due to airway obstruction was significantly higher value PetCO2 85 mmHg. The pH value of the blood in all scenarios fell from 7,42 to 7,34. At the beginning of asphyxia simulator compensatory mechanisms lifted heart beat frequency from 72 to 152 beats per minute, followed by VT with a pulse, which after one minute into VF and a further one minute of cardiac arrest. Cardiac output was from 6 L/min at 4 L/min at the beginning of VT and fall in value incompatible with life (0,1 L/min) at the beginning of asystole. We note that the simulator METI HPS corresponds to the presentation of asphyxia and is suitable for the teaching of such scenarios in education.
Databáze: OpenAIRE
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