Pulsatile reperfusion after cardiac arrest improves neurologic outcome

Mark P. Anstadt, Michael J. Stonnington, Mark Tedder, Barbara J. Crain, Michael F. Brothers, David J. Hilleren, Richard J. Rahija, J. Alan Menius, James E. Lowe

Research output: Contribution to journalArticle

Abstract

Cardiopulmonary bypass (CPB) using nonpulsatile flow (NPF) is advocated for refractory cardiac arrest. This study examined cerebral outcome after resuscitation with pulsatile flow (PF) versus NPF. Dogs arrested for 12.5 minute were reperfused with NPF (n = 11) using roller pump CPB or PF (n = 11) using mechanical biventricular cardiac massage. Pump flows were similar between groups; however early arterial pressures were greater during PF versus NPF, *p <0.05. Circulatory support was weaned at 60 minutes' reperfusion. Neurologic recovery of survivors (n = 16) was significantly better after PF versus NPF, *p =0.01. The presence of brain lesions on magnetic resonance images did not significantly differ between groups at 7 days. Brains then were removed and regions examined for ischemic changes. Loss of CA1 pyramidal neurons was more severe after NPF versus PF, †p = 0.009. Ischemic changes were more frequent after NPF in the caudate nucleus (†p = 0.009) and watershed regions of the cerebral cortex (†p = 0.062), compared with PF. These results demonstrate that PF improves cerebral resuscitation when treating cardiac arrest with mechanical circulatory support (* = MANOVA with repeated measures, † = categorical data analysis).

Original languageEnglish (US)
Pages (from-to)478-488
Number of pages11
JournalAnnals of Surgery
Volume214
Issue number4
StatePublished - Oct 1991
Externally publishedYes

Fingerprint

Pulsatile Flow
Heart Arrest
Nervous System
Reperfusion
Cardiopulmonary Bypass
Resuscitation
Heart Massage
Pyramidal Cells
Caudate Nucleus
Brain
Cerebral Cortex
Arterial Pressure
Magnetic Resonance Spectroscopy
Dogs

ASJC Scopus subject areas

  • Surgery

Cite this

Anstadt, M. P., Stonnington, M. J., Tedder, M., Crain, B. J., Brothers, M. F., Hilleren, D. J., ... Lowe, J. E. (1991). Pulsatile reperfusion after cardiac arrest improves neurologic outcome. Annals of Surgery, 214(4), 478-488.

Pulsatile reperfusion after cardiac arrest improves neurologic outcome. / Anstadt, Mark P.; Stonnington, Michael J.; Tedder, Mark; Crain, Barbara J.; Brothers, Michael F.; Hilleren, David J.; Rahija, Richard J.; Menius, J. Alan; Lowe, James E.

In: Annals of Surgery, Vol. 214, No. 4, 10.1991, p. 478-488.

Research output: Contribution to journalArticle

Anstadt, MP, Stonnington, MJ, Tedder, M, Crain, BJ, Brothers, MF, Hilleren, DJ, Rahija, RJ, Menius, JA & Lowe, JE 1991, 'Pulsatile reperfusion after cardiac arrest improves neurologic outcome', Annals of Surgery, vol. 214, no. 4, pp. 478-488.
Anstadt MP, Stonnington MJ, Tedder M, Crain BJ, Brothers MF, Hilleren DJ et al. Pulsatile reperfusion after cardiac arrest improves neurologic outcome. Annals of Surgery. 1991 Oct;214(4):478-488.
Anstadt, Mark P. ; Stonnington, Michael J. ; Tedder, Mark ; Crain, Barbara J. ; Brothers, Michael F. ; Hilleren, David J. ; Rahija, Richard J. ; Menius, J. Alan ; Lowe, James E. / Pulsatile reperfusion after cardiac arrest improves neurologic outcome. In: Annals of Surgery. 1991 ; Vol. 214, No. 4. pp. 478-488.
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