Perfluorocarbon induced intra-arrest hypothermia does not improve survival in a swine model of asphyxial cardiac arrest.

Abstract:

BACKGROUND:Pulseless electrical activity is an important cause of cardiac arrest. Our purpose was to determine if induction of hypothermia with a cold perfluorocarbon-based total liquid ventilation (TLV) system would improve resuscitation success in a swine model of asphyxial cardiac arrest/PEA. METHODS:Twenty swine were randomly assigned to control (C, no ventilation, n=11) or TLV with pre-cooled PFC (n=9) groups. Asphyxia was induced by insertion of a stopper into the endotracheal tube, and continued in both groups until loss of aortic pulsations (LOAP) was reached, defined as a pulse pressure less than 2mmHg. The TLV animals underwent asphyxial arrest for an additional 2min after LOAP, followed by 3min of hypothermia, prior to starting CPR. The C animals underwent 5min of asphyxia beyond LOAP. Both groups then underwent CPR for at least 10min. The endpoint was the resumption of spontaneous circulation maintained for 10min. RESULTS:Seven of 9 animals achieved resumption of spontaneous circulation (ROSC) in the TLV group vs. 5 of 11 in the C group (p=0.2). The mean pulmonary arterial temperature was lower in total liquid ventilation animals starting 4min after induction of hypothermia (TLV 36.3+/-0.2 degrees C vs. C 38.1+/-0.2 degrees C, p<0.0001). Arterial P(O)(2) was higher in total liquid ventilation animals at 2.5min of CPR (TLV 76+/-12mmHg vs. C 44+/-2mmHg; p=0.03). CONCLUSION:Induction of moderate hypothermia using perfluorocarbon-based total liquid ventilation did not improve ROSC success in this model of asphyxial cardiac arrest.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Albaghdadi AS,Brooks LA,Pretorius AM,Kerber RE

doi

10.1016/j.resuscitation.2009.11.018

subject

Has Abstract

pub_date

2010-03-01 00:00:00

pages

353-8

issue

3

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(09)00621-2

journal_volume

81

pub_type

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