Organ blood flow following cardiac arrest in a swine low-flow cardiopulmonary bypass model

Angelos, Mark G.; Ward, Kevin R.; Hobson, Jamie; Beckley, P.

doi:10.1016/0300-9572(94)90038-8

Cited by 26 publications

(15 citation statements)

References 35 publications

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“…Delivery of electrical shocks of higher energy during high-flow ECC eventually terminated VF and reestablished cardiac activity in each instance. High-flow ECC maintained the mean aortic pressure at 40 mmHg and resulted in a coronary blood flow of ~ 180% of baseline, likely the result of reactive hyperemia [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Ventricular Fibrillation Waveform Changes during Controlled Coronary Perfusion Using Extracorporeal Circulation in a Swine Model

et al. 2016

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BackgroundSeveral characteristics of the ventricular fibrillation (VF) waveform have been found predictive of successful defibrillation and hypothesized to reflect the myocardial energy state. In an open-chest swine model of VF, we modeled “average CPR” using extracorporeal circulation (ECC) and assessed the time course of coronary blood flow, myocardial metabolism, and myocardial structure in relation to the amplitude spectral area (AMSA) of the VF waveform without artifacts related to chest compression.MethodsVF was induced and left untreated for 8 minutes in 16 swine. ECC was then started adjusting its flow to maintain a coronary perfusion pressure of 10 mmHg for 10 minutes. AMSA was calculated in the frequency domain and analyzed continuously with a 2.1 s timeframe and a Tukey window that moved ahead every 0.5 s.ResultsAMSA progressively declined during untreated VF. With ECC, AMSA increased from 7.0 ± 1.9 mV·Hz (at minute 8) to 12.8 ± 3.3 mV·Hz (at minute 14) (p < 0.05) without subsequent increase and showing a modest correlation with coronary blood flow of borderline statistical significance (r = 0.489, p = 0.0547). Myocardial energy measurements showed marked reduction in phosphocreatine and moderate reduction in ATP with increases in ADP, AMP, and adenosine along with myocardial lactate, all indicative of ischemia. Yet, ischemia did not resolve during ECC despite a coronary blood flow of ~ 30% of baseline.ConclusionAMSA increased upon return of coronary blood flow during ECC. However, the maximal level was reached after ~ 6 minutes without further change. The significance of the findings for determining the optimal timing for delivering an electrical shock during resuscitation from VF remains to be further explored.

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Section: Discussionmentioning

confidence: 99%

Ventricular Fibrillation Waveform Changes during Controlled Coronary Perfusion Using Extracorporeal Circulation in a Swine Model

et al. 2016

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“…Unmittelbar nach ROSC gibt es eine Phase zerebraler Hyperämie [671]. Nach asphyktischem Kreislaufstillstand kann nach ROSC vorübergehend ein Hirnödem auf-treten; dies ist aber selten mit klinisch relevanten Hirndruckanstiegen verbunden [672,673].…”

Section: Behinderung (Optimierung Der Neurologischen Erholung) Zerebrunclassified

Erweiterte Reanimationsmaßnahmen für Erwachsene („advanced life support“)

Deakin

Nolan

Soar

et al. 2010

Notfall Rettungsmed

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“…Immediately after ROSC a period of 15 to 30 minutes of hyperaemia, i.e. "high flow" occurs (Angelos et al 1994). This aggravates pre-existing cerebral oedema and microhaemorrhages that develop due to ischaemic capillary lesions (Greer 2006).…”

Section: Reperfusion Injurymentioning

confidence: 99%

Pre‐hospital cardiac arrest and induction of mild hypothermia: studies on epidemiology and feasibility

Kämäräinen¹

2010

Acta Anaesthesiol Scand

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Organ blood flow following cardiac arrest in a swine low-flow cardiopulmonary bypass model

Cited by 26 publications

References 35 publications

Ventricular Fibrillation Waveform Changes during Controlled Coronary Perfusion Using Extracorporeal Circulation in a Swine Model

Ventricular Fibrillation Waveform Changes during Controlled Coronary Perfusion Using Extracorporeal Circulation in a Swine Model

Erweiterte Reanimationsmaßnahmen für Erwachsene („advanced life support“)

Pre‐hospital cardiac arrest and induction of mild hypothermia: studies on epidemiology and feasibility

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