内科学教学课件：Cardiac Arrest and CPR.pptVIP

Indication of NB complemen’tarity be sure that circulation has stopped for at least 10min be sure that metabolic acidosis and hyperkalemia have occur. About 95％ of the drowning show metabolic acidosis depend on blood gas analysis , metabolic alkalosis even worse. Manage after CPR Maintain effective circulation: entirely estimate state of illness, make out correct treatment evaluation. Maintain breath：machine ventilation, oxygen therapy, positive end-expiratory pressure (PEEP). Prevent and treat cerebral ischemia and edema: the key that CPR succeed, body temperature decrease to 33-34℃; cerebral dehydrate ; prevent and treat convulsion; hyperbaric oxygen therapy; promote early cerebral blood flux infusion. Prevent and treat ARF: maintain heart and circulation function, avoid nephrotoxic drugs. Correct acid-base and electrolytic disturbance, prevent and treat secondary infection. methods Cerebral dehydrate: this progress go on with decreasing body temperature, the common drug 20% mannitol, mannitol has better effect to clean brain free radicals. Diuretics can be used together. Prevent and treat convulsion: ataractic镇静剂 Promote brain blood flux infusion: CCB, researches have testified that CCB can increase cardiac output and relieve nerve tissue damage Correct hypoxia: hypoxia must occur after cardiac arrest, myocardial hypoxia is the biggest obstructive factor for CPR succeed, cerebral hypoxia is the important origin of cerebral edema, also important factor to baffle respiration recovery, so during the whole process of CPR, it’s necessary to adopt a series of measure to correct hypoxia, such as keeping respiratory tract patency, positive pressure ventilation, etc. Administrating respiratory stimulant （1）indication：there is spontaneous breath, but it’s respiratory insufficiency. （2）administrating time: Till 1 hour after CPR succeed. Prevent cardiac arrest Treat coronary heart disease(ACEI,β) Use amiodarone to control frequent ventricular arrythmia Implantable