Carotid artery and cerebral blood flow during experimental cardiopulmonary resuscitation: A systematic review of the literature

Lucchetta, Luca; Kwan, Timothy N; Kosaka, Junko; Tanaka, Aiko; Eastwood, Glenn M; Chan, Matthew J.; Mårtensson, Johan; May, Clive; Bellomo, Rinaldo

doi:10.1016/j.resuscitation.2019.02.016

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…In this study, the use of REBOA significantly raised CBF to 61% of the baseline value despite an ongoing ACT. This can be related to a mean CBF of 47% compared to the baseline value achieved during CPR in pigs with cardiac arrest reported in other studies (39). When considering long-term recovery, it is possible that this temporary increase in cerebral perfusion may lead to a better neurological outcome, however, it is difficult to estimate what level of CBF is required is such cases.…”

Section: Discussionmentioning

confidence: 91%

Hemodynamic Effect of Resuscitative Endovascular Balloon Occlusion of the Aorta in Hemodynamic Instability Secondary to Acute Cardiac Tamponade in a Porcine Model

McGreevy

Björklund

Nilsson

et al. 2021

Shock

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Background: The pre-hospital use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is increasing, although it remains controversial, in part because of suggested contraindications such as acute cardiac tamponade (ACT). As both the pre-hospital and in-hospital use of REBOA might potentially occur with concurrent ACT, knowledge of the hemodynamic effect of REBOA in this setting is crucial. This study, therefore, aimed at investigating the physiological effects of REBOA in hemodynamic instability secondary to ACT in a porcine model. We hypothesize that REBOA can temporarily increase systemic blood pressure and carotid blood flow, and prolong survival, in hemodynamic shock caused by ACT. Methods: Fourteen pigs (24-38 kg) underwent ACT, through true cardiac injury and hemorrhage into the pericardial space, and were allowed to hemodynamically deteriorate. At a systolic blood pressure (SBP) of 50 mm Hg (SBP50) they were randomized to total occlusion REBOA in zone 1 or to a control group. Survival, hemodynamic parameters, carotid blood flow (CBF), femoral blood flow (FBF), cardiac output (CO), end-tidal CO 2 , and arterial blood gas parameters were analyzed. Results: REBOA intervention was associated with a significant increase in SBP (50 mm Hg to 74 mm Hg, P ¼ 0.016) and CBF (110 mL/min to 195 mL/min, P ¼ 0.031), with no change in CO, compared to the control group. At 20 min after SBP50, the survival rate in the intervention group was 86% and in the control group 14%, with time to death being significantly longer in the intervention group. Conclusions: This randomized animal study demonstrates that REBOA can help provide hemodynamic stabilization and prolong survival in hemodynamic shock provoked by ACT. It is important to stress that our study does not change the fact that urgent pericardiocentesis or cardiac surgery is, and should remain, the standard optimal treatment for ACT.

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Section: Discussionmentioning

confidence: 91%

Hemodynamic Effect of Resuscitative Endovascular Balloon Occlusion of the Aorta in Hemodynamic Instability Secondary to Acute Cardiac Tamponade in a Porcine Model

McGreevy

Björklund

Nilsson

et al. 2021

Shock

View full text Add to dashboard Cite

show abstract

“…Although CePP increases with vasopressors, CBF significantly drops and the relationship between those parameters and their effect on neurological outcome remains unclear. 22 , 23 But, by stimulating ß-adrenergic receptors, epinephrine also increases the myocardial oxygen consumption and thus increases the severity of myocardial infarction. 10 , 24 After ROSC, ß-adrenergic inotropes are prone to induce arrhythmias and more severe post-arrest myocardial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

The cerebral and cardiac effects of Norepinephrine in an experimental cardiac arrest model

Jaeger,

Kosmopoulos,

Gaisendrees

et al. 2024

Resuscitation Plus

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Automated pupillometry helps monitor the efficacy of cardiopulmonary resuscitation and predict return of spontaneous circulation

Shi

Wang³

et al. 2021

The American Journal of Emergency Medicine

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Carotid artery and cerebral blood flow during experimental cardiopulmonary resuscitation: A systematic review of the literature

Cited by 4 publications

References 16 publications

Hemodynamic Effect of Resuscitative Endovascular Balloon Occlusion of the Aorta in Hemodynamic Instability Secondary to Acute Cardiac Tamponade in a Porcine Model

Hemodynamic Effect of Resuscitative Endovascular Balloon Occlusion of the Aorta in Hemodynamic Instability Secondary to Acute Cardiac Tamponade in a Porcine Model

The cerebral and cardiac effects of Norepinephrine in an experimental cardiac arrest model

Automated pupillometry helps monitor the efficacy of cardiopulmonary resuscitation and predict return of spontaneous circulation

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