Pralidoxime-Induced Potentiation of the Pressor Effect of Adrenaline and Hastened Successful Resuscitation by Pralidoxime in a Porcine Cardiac Arrest Model

Lee, Hyoung Youn; Mamadjonov, Najmiddin; Jeung, Kyung Woon; Jung, Yong Hun; Lee, Byung Kook; Moon, Kyung‐Sub; Heo, Tag; Min, Yong‐Ki

doi:10.1007/s10557-020-07026-5

Cited by 4 publications

(4 citation statements)

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“…Since arterial blood gases were measured only at three timepoints (3, 15, and 60 min) after ROSC, PaO 2 data were not available for several timepoints at which the other target variables were sampled. In the original study [27], we found that PaO 2 levels linearly increased over time during the 60-min postresuscitation period. Thus, PaO 2 values at unmeasured timepoints were derived using linear interpolation and extrapolation methods.…”

Section: Discussionmentioning

confidence: 84%

“…This study was a post-hoc analysis of data derived from a previous study investigating the effects of pralidoxime administration during cardiopulmonary resuscitation (CPR) on hemodynamics and cerebral microcirculation after ROSC in 20 healthy Yorkshire/Landrace cross pigs weighing 24.7 ± 1.7 kg [27]. In this study, data from 10 animals that received only standard advanced cardiovascular life support (control group) were included.…”

Section: Methodsmentioning

confidence: 99%

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Relationship of common hemodynamic and respiratory target parameters with brain tissue oxygen tension in the absence of hypoxemia or hypotension after cardiac arrest: A post-hoc analysis of an experimental study using a pig model

et al. 2021

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Brain tissue oxygen tension (PbtO2)-guided care, a therapeutic strategy to treat or prevent cerebral hypoxia through modifying determinants of cerebral oxygen delivery, including arterial oxygen tension (PaO2), end-tidal carbon dioxide (ETCO2), and mean arterial pressure (MAP), has recently been introduced. Studies have reported that cerebral hypoxia occurs after cardiac arrest in the absence of hypoxemia or hypotension. To obtain preliminary information on the degree to which PbtO2 is responsive to changes in the common target variables for PbtO2-guided care in conditions without hypoxemia or hypotension, we investigated the relationships between the common target variables for PbtO2-guided care and PbtO2 using data from an experimental study in which the animals did not experience hypoxemia or hypotension after resuscitation. We retrospectively analyzed 170 sets of MAP, ETCO2, PaO2, PbtO2, and cerebral microcirculation parameters obtained during the 60-min post-resuscitation period in 10 pigs resuscitated from ventricular fibrillation cardiac arrest. PbtO2 and cerebral microcirculation parameters were measured on parietal cortices exposed through burr holes. Multiple linear mixed effect models were used to test the independent effects of each variable on PbtO2. Despite the absence of arterial hypoxemia or hypotension, seven (70%) animals experienced cerebral hypoxia (defined as PbtO2 <20 mmHg). Linear mixed effect models revealed that neither MAP nor ETCO2 were related to PbtO2. PaO2 had a significant linear relationship with PbtO2 after adjusting for significant covariates (P = 0.030), but it could explain only 17.5% of the total PbtO2 variance (semi-partial R2 = 0.175; 95% confidence interval, 0.086–0.282). In conclusion, MAP and ETCO2 were not significantly related to PbtO2 in animals without hypoxemia or hypotension during the early post-resuscitation period. PaO2 had a significant linear association with PbtO2, but its ability to explain PbtO2 variance was small.

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Section: Discussionmentioning

confidence: 84%

Section: Methodsmentioning

confidence: 99%

Relationship of common hemodynamic and respiratory target parameters with brain tissue oxygen tension in the absence of hypoxemia or hypotension after cardiac arrest: A post-hoc analysis of an experimental study using a pig model

et al. 2021

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“…The anesthesia, preparation, and data collection procedures have been previously described. 27 , 28 , 29 , 30 Briefly, following initial sedation with intramuscular administration of ketamine (20 mg/kg) and xylazine (2.2 mg/kg), the animals were tracheostomized and mechanically ventilated with a 70/30 mixture of N 2 O/O 2 and sevoflurane (titrated to maintain adequate anesthesia). An end‐tidal carbon dioxide sampling line was placed between the ventilator circuit and tracheal tube.…”

Section: Methodsmentioning

confidence: 99%

Effects of Sodium Nitroprusside Administered Via a Subdural Intracranial Catheter on the Microcirculation, Oxygenation, and Electrocortical Activity of the Cerebral Cortex in a Pig Cardiac Arrest Model

Lee

Jung

Mamadjonov

et al. 2022

JAHA

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Background Postischemic cerebral hypoperfusion has been indicated as an important contributing factor to secondary cerebral injury after cardiac arrest. We evaluated the effects of sodium nitroprusside administered via a subdural intracranial catheter on the microcirculation, oxygenation, and electrocortical activity of the cerebral cortex in the early postresuscitation period using a pig model of cardiac arrest. Methods and Results Twenty‐nine pigs were resuscitated with closed cardiopulmonary resuscitation after 14 minutes of untreated ventricular fibrillation. Thirty minutes after restoration of spontaneous circulation, 24 pigs randomly received either 4 mg of sodium nitroprusside (IT‐SNP group) or saline placebo (IT‐saline group) via subdural intracranial catheters and were observed for 5 hours. The same dose of sodium nitroprusside was administered intravenously in another 5 pigs. Compared with the IT‐saline group, the IT‐SNP group had larger areas under the curve for tissue oxygen tension and percent changes of arteriole diameter and number of perfused microvessels from baseline (all P <0.05) monitored on the cerebral cortex during the 5‐hour period, without severe hemodynamic instability. This group also showed faster recovery of electrocortical activity measured using amplitude‐integrated electroencephalography. Repeated‐measures analysis of variance revealed significant group–time interactions for these parameters. Intravenously administered sodium nitroprusside caused profound hypotension but did not appear to increase the cerebral parameters. Conclusions Sodium nitroprusside administered via a subdural intracranial catheter increased post–restoration of spontaneous circulation cerebral cortical microcirculation and oxygenation and hastened electrocortical activity recovery in a pig model of cardiac arrest. Further studies are required to determine its impact on the long‐term neurologic outcomes.

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“…First, we were unable to stratify the types of CPR interventions due to the heterogeneity of CPR interventions (including defibrillation, anti-arrhythmic drugs, adrenergic drugs, and mechanical CPR). Efforts were made to provide specific information in each article in Supplementary Material B [40–256] to identify the type of VF induction used in the experiment of interest. Second, the quality of the included studies was not assessed.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of swine models for ventricular fibrillation induction in evaluating cardiopulmonary resuscitation methods

Low,

Azahar,

Samson

et al. 2024

Cardiology Plus

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Background and purpose: Ventricular fibrillation (VF) has been studied using a variety of swine models, historically balloon occlusion of the coronary artery and asphyxiation, and more recently, percutaneous electrical induction. These methods differ in face and construct validity, as well as requirement for expertise, cost, and duration. This study aimed to provide a systematic review these methods and their selection in research. Methods: Electronic searches were conducted in PubMed, Scopus, and Google Scholar. The Utstein-Style Guidelines for Uniform Reporting of Laboratory cardiopulmonary resuscitation (CPR) research were used to identify the extracted variables by two independent investigators. Discrepancy was resolved by discussion with the third investigator. Results: We included 236 studies published from 1990 to 2024. The most commonly used method was electrical induction using a pacing wire cannulated through the external jugular vein into the right ventricle (n = 112), followed by transthoracic electrical induction (n = 28), asphyxiation (n = 20), electrical induction via two subcutaneous needles (n = 15), and balloon occlusion (n = 10). The mean and standard deviation (SD) of the untreated VF duration were 6.9 and 5.0 minutes, respectively. Female and male pigs were used exclusively in 52 and 45 studies, respectively; both sexes were used in 31 studies; 106 studies not reporting the sex. The mean weight of the pigs was 30.2 ± 12.4 kg in 209 studies, and the number of pigs used in the studies ranged from 2 to 271 with a median of 20 (interquartile range: 15–30) pigs in 223 studies. The four most commonly used drugs for anesthesia/preparation were ketamine (n = 145), propofol (n = 76), isoflurane (n = 68), and pentobarbital (n = 61), either alone or in combination. Higher current and voltage were used for less invasive methods. Conclusions: The two most common electric method to induce VF were invasive pacing at the right ventricle and non-invasive transthoracic electrical induction. Asphyxiation was the most common ischemic VF induction. The choice of the VF induction method depends on cost, expertise, feasibility, and the nature of the CPR intervention to be tested.

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Pralidoxime-Induced Potentiation of the Pressor Effect of Adrenaline and Hastened Successful Resuscitation by Pralidoxime in a Porcine Cardiac Arrest Model

Cited by 4 publications

References 36 publications

Relationship of common hemodynamic and respiratory target parameters with brain tissue oxygen tension in the absence of hypoxemia or hypotension after cardiac arrest: A post-hoc analysis of an experimental study using a pig model

Relationship of common hemodynamic and respiratory target parameters with brain tissue oxygen tension in the absence of hypoxemia or hypotension after cardiac arrest: A post-hoc analysis of an experimental study using a pig model

Effects of Sodium Nitroprusside Administered Via a Subdural Intracranial Catheter on the Microcirculation, Oxygenation, and Electrocortical Activity of the Cerebral Cortex in a Pig Cardiac Arrest Model

Systematic review of swine models for ventricular fibrillation induction in evaluating cardiopulmonary resuscitation methods

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