Ischemic postconditioning at the initiation of cardiopulmonary resuscitation facilitates functional cardiac and cerebral recovery after prolonged untreated ventricular fibrillation

Nicolas Segal, Timothy Matsuura, Emily Caldwell, Mohammad Sarraf, Scott McKnite, Menekhem Zviman, Tom P. Aufderheide, Henry R Halperin, Keith G. Lurie, Demetris Yannopoulos

Research output: Contribution to journalArticle

Abstract

Objectives: Ischemic postconditioning (PC) with " stuttering" reintroduction of blood flow after prolonged ischemia has been shown to offer protection from ischemia reperfusion injury to the myocardium and brain. We hypothesized that four 20-s pauses during the first 3. min of standard CPR would improve post resuscitation cardiac and neurological function, in a porcine model of prolonged untreated cardiac arrest. Methods: 18 female farm pigs, intubated and isoflurane anesthetized had 15. min of untreated ventricular fibrillation followed by standard CPR (SCPR). Nine animals were randomized to receive PC with four, controlled, 20-s pauses, during the first 3. min of CPR (SCPR. +. PC). Resuscitated animals had echocardiographic evaluation of their ejection fraction after 1 and 4. h and a blinded neurological assessment with a cerebral performance category (CPC) score assigned at 24 and 48. h. All animals received 12. h of post resuscitation mild therapeutic hypothermia. Results: SCPR. +. PC animals had significant improvement in left ventricular ejection fraction at 1 and 4. h compared to SCPR (59 ± 11% vs 35 ± 7% and 55 ± 8% vs 31 ± 13% respectively, p

Original languageEnglish (US)
Pages (from-to)1397-1403
Number of pages7
JournalResuscitation
Volume83
Issue number11
DOIs
StatePublished - Nov 2012

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Ischemic Postconditioning
Cardiopulmonary Resuscitation
Ventricular Fibrillation
Resuscitation
Swine
Induced Hypothermia
Stuttering
Isoflurane
Heart Arrest
Reperfusion Injury
Stroke Volume
Myocardium
Ischemia
Brain

Keywords

  • Cardiopulmonary resuscitation
  • Left ventricular function
  • Neurological function
  • Post conditioning
  • Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

Cite this

Ischemic postconditioning at the initiation of cardiopulmonary resuscitation facilitates functional cardiac and cerebral recovery after prolonged untreated ventricular fibrillation. / Segal, Nicolas; Matsuura, Timothy; Caldwell, Emily; Sarraf, Mohammad; McKnite, Scott; Zviman, Menekhem; Aufderheide, Tom P.; Halperin, Henry R; Lurie, Keith G.; Yannopoulos, Demetris.

In: Resuscitation, Vol. 83, No. 11, 11.2012, p. 1397-1403.

Research output: Contribution to journalArticle

Segal, Nicolas ; Matsuura, Timothy ; Caldwell, Emily ; Sarraf, Mohammad ; McKnite, Scott ; Zviman, Menekhem ; Aufderheide, Tom P. ; Halperin, Henry R ; Lurie, Keith G. ; Yannopoulos, Demetris. / Ischemic postconditioning at the initiation of cardiopulmonary resuscitation facilitates functional cardiac and cerebral recovery after prolonged untreated ventricular fibrillation. In: Resuscitation. 2012 ; Vol. 83, No. 11. pp. 1397-1403.
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