[Changes in acid-base status, potassium ions and glucose concentrations in blood during cardiopulmonary resuscitation. Study of the significance of animal experiment results in emergency medicine case examples].
Results obtained during animal investigations cannot be directly applied to patients because of the anatomical and physiological differences present. Experience has shown that cases of sudden cardiac arrest can only be effectively helped if cardiac massage and artificial ventilation are carried out as soon as possible, and that no sodium bicarbonate need be given when resuscitation measures are begun immediately, or very soon after arrest. In this situation it is better to use adrenaline only, in order to improve organ perfusion. The examples presented show that giving bicarbonate can alter potassium kinetics. Very low serum potassium concentrations are often measured during and following successful resuscitation, and giving too large an amount of buffer solution can worsen this hypokalaemia and lead to a further arrest. The infusion of sodium bicarbonate and the rapid increase in blood sugar levels during resuscitation can lead to a marked rise in serum osmolality which in turn can jeopardize the return of cerebral function. Because in the presence of reduced cerebral perfusion, high blood glucose levels increase the degree of cerebral lactacidosis blood glucose levels should be measured and corrected as necessary.
D000136:Acid-Base Equilibrium / Q000187:drug effects; D001639:Bicarbonates / Q000008:administration & dosage; D001786:Blood Glucose / Q000378:metabolism*; D002118:Calcium / Q000097:blood; D002245:Carbon Dioxide / Q000097:blood; D002648:Child; D004837:Epinephrine / Q000008:administration & dosage; D006323:Heart Arrest / Q000097:blood / Q000628:therapy*; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011188:Potassium / Q000097:blood*; D012151:Resuscitation; D012964:Sodium / Q000008:administration & dosage; D017693:Sodium Bicarbonate; D014882:Water-Electrolyte Balance / Q000187:drug effects
D001639:Bicarbonates; D001786:Blood Glucose; D002245:Carbon Dioxide; D017693:Sodium Bicarbonate; D012964:Sodium; D011188:Potassium; D010100:Oxygen; D002118:Calcium; D004837:Epinephrine
Veränderungen des Säuren-Basen-Status, der Kaliumionen- und Glukosekonzentrationen im Blut während der kardiopulmonalen Reanimation. Versuch einer Deutung tierexperimenteller Ergebnisse an notfallmedizinischen Fallbeispielen.