Intralipid infusion diminishes return of spontaneous circulation after hypoxic cardiac arrest in rabbits.

Abstract:

BACKGROUND:Infusion of lipid emulsion has been shown to reverse lipophilic drug-induced cardiovascular collapse in laboratory models and humans. The effect of high dose lipid in nondrug-induced cardiac arrest is, however, uncertain. In a rabbit model of asphyxial pulseless electrical activity (PEA) we compared lipid augmented with standard advanced cardiac life support (ACLS) resuscitation. METHOD:Adult New Zealand White rabbits underwent hypoxic PEA via tracheal clamping. After 2 min of cardiac arrest, basic life support cardiopulmonary resuscitation was commenced and 3 mL/kg 20% Intralipid or 3 mL/kg 0.9% saline solution infused. Adrenaline (100 microg/kg) was administered at 4 and 5 min. Return of spontaneous circulation (ROSC), hemodynamic metrics, and survival to 50 min were recorded. RESULTS:Seven of 11 saline-treated rabbits developed ROSC versus 1 of 12 Intralipid-treated animals; P = 0.009. No significant difference in survival to 50 min was observed (3/11 saline vs 0/12 Intralipid; P = 0.211). CONCLUSION:In this model of hypoxia-induced PEA, standard ACLS resulted in greater coronary perfusion pressure and increased ROSC compared with ACLS plus lipid infusion. Lipid emulsion may be contraindicated in cardiac arrest complicated by significant hypoxia.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Harvey M,Cave G,Kazemi A

doi

10.1213/ane.0b013e31819367ba

subject

Has Abstract

pub_date

2009-04-01 00:00:00

pages

1163-8

issue

4

eissn

0003-2999

issn

1526-7598

pii

108/4/1163

journal_volume

108

pub_type

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