人為的心拍停止法に関する実験的並びに臨床的研究 : 特に電気的心室細動法について

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  • Experimental and Clinical Studies on Induced Cardiac Arrest: with Special Reference to Electrical Ventricular Fibrillation
  • ジンイテキ シンパク テイシホウ ニ カンスル ジッケンテキ ナラビニ リンショウテキ ケンキュウ トクニ デンキテキ シンシツサイドウホウ ニ ツイテ

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Various techniques of induced cardiac arrest, which allows the surgeon a motionless and dry field for facilitating a safe and easy intercardiac surgery, have been deviced by a number of investigators. Induced cardiac arrest is at the same time useful for reducing or totally preventing the possibilities of air embolism into the coronary or cerebral circulation. A method of anoxic arrest induced by crossclamping the aorta above the valve, in combination with or without hypothermia, has been widely used. However, controversy continues as to whether myocardial hypoxia produced by anoxic arrest might severely impair postoperative cardiac performance in addition to any trauma caused by the operative procedure. Another generally used method for induced cardiac arrest is induced electrical fibrillation, which provides a non-contracting heart, maintaining it in the active state of ventricular fibrillation, though venous return from the coronary sinus and Thebesian veins may be some nusance to dry operative field. The author has adopted electrical ventricular fibrillation as an effective means of induced cardiac arrest and has originally devised an accurately operable fibrillator. Since its usefulness was observed as the results of some experimental studies on it, it has successfully been employed in clinical application. The purpose of this report is to describe some noticeable results of the experimental studies an clinical application, with some discussion. I. The apparatus The fibrillator deviced by the author can be used for applying an alternating current or a direct current, and is equipped with an ammeter, a timer and a voltmeter for measuring. Two types of the electrode are provided for use : in one of them each electrode is made of a stainless-steel disc, in another type one electrode is made of a steel disc and the other of a steel clip.

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