特殊情况下的CPR资料.ppt

Shift potassium into cells: 促使钾转移至细胞内 Sodium bicarbonate碳酸氢钠: 50 mEq IV over 5 minutes Glucose plus insulin葡萄糖加胰岛素: mix 25 g (50 mL of D50) glucose and 10 U regular insulin and give IV over 15 to 30 minutes Nebulized albuterol 雾化沙丁胺醇: 10 to 20 mg nebulized over 15 minutes Promote potassium excretion: 促进钾的排出 Diuresis利尿: furosemide 速尿40 to 80 mg IV Kayexalate降钾树脂: 15 to 50 g plus sorbitol per oral or per rectum Dialysis 透析 Hypokalemia can produce ECG changes such as U waves, T-wave flattening, and arrhythmias (especially if the patient is taking digoxin), particularly ventricular arrhythmias, which, if left untreated, deteriorate to PEA or asystole.低钾血症ECG表现为U波、T波低平、心律失常（尤其正在使用地高辛的患者），尤其是室性心律失常，未处理可恶化为无脉性电活动 或心跳静止。 Disturbances in sodium level are unlikely to be the primary cause of severe cardiovascular instability.血钠的失衡不太可能是严重心血管循环不稳定的初始原因。 Hypermagnesemia高镁血症 Hypermagnesemia is defined as a serum magnesium concentration 2.2 mEq/L (normal: 1.3 to 2.2 mEq/L). Neurological symptoms of hypermagnesemia include muscular weakness, paralysis, ataxia, drowsiness, and confusion. Hypermagnesemia can produce vasodilation and hypotension. 高镁血症是指血清镁浓度超过2.2 mEq/L（正常值为 1.3 to 2.2 mEq/L）。高镁血症的神经症状包括：肌无力、麻痹、共共济失调、昏昏欲睡、神志恍惚。高镁血症可导致血管扩张和低血压。 Hypermagnesemia高镁血症 Extremely high serum magnesium levels may produce a depressed level of consciousness, bradycardia, cardiac arrhythmias, hypoventilation, and cardiorespiratory arrest.极度的高镁血症可使神志消失、心动过缓、心律失常、低通气、心跳呼吸骤停。 Administration of calcium (calcium chloride [10%] 5 to 10 mL or calcium gluconate [10%] 15 to 30 mL IV over 2 to 5 minutes) may be considered during cardiac arrest associated with hypermagnesemia对于与高镁血症相关的心跳骤停，可给予钙剂（10%氯化钙5 to 10 mL 或10%葡萄糖酸钙15 to 30 mL IV 2-5分钟） Hypomagnesemia低镁血症 Hypomagnesemia can be associated with polymorphic ventricular tachycardia, including torsades de pointes, a pulseless form (polymorphic) of ventricular tachycardia. 低镁血症与多形性室速有关，包括尖端扭转、无脉室速。 For cardiotoxicity and cardiac arrest, IV magne