Risk Factor Analyses for the Return of Spontaneous Circulation in the Asphyxiation Cardiac Arrest Porcine Model

Abstract

Background:Animal models of asphyxiation cardiac arrest (ACA) are frequently used in basic research to mirror the clinical course of cardiac arrest (CA). The rates of the return of spontaneous circulation (ROSC) in ACA animal models are lower than those from studies that have utilized ventricular fibrillation (VF) animal models. The purpose of this study was to characterize the factors associated with the ROSC in the ACA porcine model.Methods:Forty-eight healthy miniature pigs underwent endotracheal tube clamping to induce CA. Once induced, CA was maintained untreated for a period of 8 min. Two minutes following the initiation of cardiopulmonary resuscitation (CPR), defibrillation was attempted until ROSC was achieved or the animal died. To assess the factors associated with ROSC in this CA model, logistic regression analyses were performed to analyze gender, the time of preparation, the amplitude spectrum area (AMSA) from the beginning of CPR and the pH at the beginning of CPR. A receiver-operating characteristic (ROC) curve was used to evaluate the predictive value of AMSA for ROSC.Results:ROSC was only 52.1% successful in this ACA porcine model. The multivariate logistic regression analyses revealed that ROSC significantly depended on the time of preparation, AMSA at the beginning of CPR and pH at the beginning of CPR. The area under the ROC curve in for AMSA at the beginning of CPR was 0.878 successful in predicting ROSC (95% confidence intervals: 0.773∼0.983), and the optimum cut-off value was 15.62 (specificity 95.7% and sensitivity 80.0%).Conclusions:The time of preparation, AMSA and the pH at the beginning of CPR were associated with ROSC in this ACA porcine model. AMSA also predicted the likelihood of ROSC in this ACA animal model.

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

“…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.…”

Combination of Hyperoxygenation and Targeted Temperature Management Improves Functional Outcomes of Post Cardiac Arrest Syndrome Irrespective of Causes of Arrest in Rats

“…Cardiac arrest (CA) is the cessation of circulation resulting from various etiologies, of which asphyxia and dysrhythmia are the two most prevalent causes in all age groups (1). Asphyxia characterized by incomplete ischemia with gradual hypoxia leads to severe myocardial and neuronal damage by progressive cellular energy depletion before the no-flow state, whereas dysrhythmia characterized by immediate ischemia with global hypoxia consumes energy rapidly (2)(3)(4). Biochemical cascades triggered by the whole-body ischemia during CA and the subsequent reperfusion after resuscitation result in post cardiac arrest syndrome (PCAS), which includes myocardial dysfunction, neurological injury, ischemia-reperfusion injury, and persistent precipitating pathology (5).…”