Cardiopulmonary resuscitation in the mouse

2002 ◽  
Vol 93 (4) ◽  
pp. 1222-1226 ◽  
Author(s):  
Lei Song ◽  
Max Harry Weil ◽  
Wanchun Tang ◽  
Shijie Sun ◽  
Tommaso Pellis
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cardiopulmonary Arrest ◽  
Threshold Level ◽  
Aortic Pressure ◽  
Coronary Perfusion Pressure ◽  
Coronary Perfusion ◽  
Successful Resuscitation ◽  
Threshold Levels ◽  
The Right

We sought to develop a model of cardiac arrest and resuscitation on mice that would be comparable to that of large mammals and would allow for more fundamental investigations on cardiopulmonary arrest and cardiac resuscitation. A model of cardiopulmonary resuscitation previously developed by our group on rats was adapted to anesthetized, mechanically ventilated adult male Institute of Cancer Research mice that weighed 46 ± 3 g. The trachea was intubated through the mouth, and end-tidal Pco 2(Pet CO2 ) was measured with a microcapnometer. Catheters were advanced into the aorta and into the right atrium, and coronary perfusion pressure (CPP) was computed. A 1.5-mA alternating current was delivered to the right ventricular endocardium, which produced ventricular fibrillation or a pulseless rhythm. Precordial compression was begun 4 min later. Ten sequential studies were performed, during which five animals were successfully resuscitated and five failed resuscitation efforts. Successful resuscitation was contingent on the restoration of threshold levels of CPP and Pet CO2 during chest compression. As in rats, swine, and human patients, threshold levels of mean aortic pressure, CPP, and Pet CO2 were critical determinates of resuscitability in this murine model of threshold level of cardiac arrest and resuscitation.

Cardiopulmonary resuscitation in the rat

1988 ◽  
Vol 65 (6) ◽  
pp. 2641-2647 ◽  
Author(s):  
I. von Planta ◽  
M. H. Weil ◽  
M. von Planta ◽  
J. Bisera ◽  
S. Bruno ◽  
...  
Keyword(s):  
Ventricular Fibrillation ◽  
Cardiopulmonary Resuscitation ◽  
Aortic Pressure ◽  
Coronary Perfusion Pressure ◽  
Low Flow ◽  
Coronary Perfusion ◽  
Flow State ◽  
Successful Resuscitation ◽  
End Tidal ◽  
The Right

A standardized method of cardiopulmonary resuscitation in rodents has been developed for anesthetized, mechanically ventilated rats. Ventricular fibrillation was induced and maintained by an alternating current delivered to the right ventricular endocardium. After 4 min of ventricular fibrillation, the chest was compressed with a pneumatic piston device. Eight of 14 animals were successfully resuscitated with DC countershock after 6 min of cardiac arrest. In confirmation of earlier studies from our laboratories in dogs, pigs, and human patients, this rodent model of cardiopulmonary resuscitation demonstrated large venoarterial [H+] and PCO2 gradients associated with reduced pulmonary excretion of CO2 during the low-flow state. Mean aortic pressure, coronary perfusion pressure, and end-tidal CO2 during chest compression were predictive of successful resuscitation.

scholarly journals Cardiopulmonary arrest and resuscitation in Landrace/Large White swine: a research model

2007 ◽  
Vol 41 (3) ◽  
pp. 353-362 ◽  
Author(s):  
T Xanthos ◽  
P Lelovas ◽  
I Vlachos ◽  
N Tsirikos-Karapanos ◽  
E Kouskouni ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Lithium Battery ◽  
Life Support ◽  
Cardiopulmonary Arrest ◽  
Advanced Life Support ◽  
Coronary Perfusion Pressure ◽  
Coronary Perfusion ◽  
Large White ◽  
Jugular Veins ◽  
Successful Resuscitation

Sudden cardiac death (SCD) is a field of continuous research. In order to answer various questions regarding SCD, several animal models have been developed. The aim of the present study is to describe our experimental model of inducing cardiac arrest in Landrace/Large White pigs, and then resuscitated according to the International Guidelines on resuscitation. Fifteen Landrace/Large White pigs were anaesthetized and intubated while spontaneously breathing. The left and right jugular veins, as well as the femoral and the carotid arteries, were surgically prepared. Induction of cardiac arrest was achieved by using an ordinary rechargeable lithium battery, through a pacemaker wire inserted into the right ventricle. The typical Advanced Life Support (ALS) protocol was followed, and in case of restoration of spontaneous circulation, the animals were further evaluated for 30 min. Seven animals were successfully resuscitated using this protocol, whereas eight failed resuscitation efforts. Successful resuscitation was contingent on the restoration of the levels of coronary perfusion pressure and PETCO2 during chest compressions. Among the different ways of inducing cardiac arrest, the ordinary lithium battery is a simple, safe and valuable technique. Landrace/Large White pigs' baseline haemodynamics closely resemble human haemodynamics, making the breed a favourable model for resuscitation.

scholarly journals Cardiac arrest complicating cardiogenic shock: from pathophysiological insights to Impella-assisted cardiopulmonary resuscitation in a pheochromocytoma-induced Takotsubo cardiomyopathy—a case report

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Filippo Zilio ◽  
Simone Muraglia ◽  
Roberto Bonmassari
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Left Ventricle ◽  
Cardiogenic Shock ◽  
Takotsubo Cardiomyopathy ◽  
Perfusion Pressure ◽  
Coronary Perfusion Pressure ◽  
Left Ventricular ◽  
Coronary Perfusion ◽  
Refractory Cardiac Arrest

Abstract Background A ‘catecholamine storm’ in a case of pheochromocytoma can lead to a transient left ventricular dysfunction similar to Takotsubo cardiomyopathy. A cardiogenic shock can thus develop, with high left ventricular end-diastolic pressure and a reduction in coronary perfusion pressure. This scenario can ultimately lead to a cardiac arrest, in which unloading the left ventricle with a peripheral left ventricular assist device (Impella®) could help in achieving the return of spontaneous circulation (ROSC). Case summary A patient affected by Takotsubo cardiomyopathy caused by a pheochromocytoma presented with cardiogenic shock that finally evolved into refractory cardiac arrest. Cardiopulmonary resuscitation was performed but ROSC was achieved only after Impella® placement. Discussion In the clinical scenario of Takotsubo cardiomyopathy due to pheochromocytoma, when cardiogenic shock develops treatment is difficult because exogenous catecholamines, required to maintain organ perfusion, could exacerbate hypertension and deteriorate the cardiomyopathy. Moreover, as the coronary perfusion pressure is critically reduced, refractory cardiac arrest could develop. Although veno-arterial extra-corporeal membrane oxygenation (va-ECMO) has been advocated as the treatment of choice for in-hospital refractory cardiac arrest, in the presence of left ventricular overload a device like Impella®, which carries fewer complications as compared to ECMO, could be effective in obtaining the ROSC by unloading the left ventricle.

Abstract 358: Aortic Balloon Occlusion Augments the Efficacy of External Cardiopulmonary Resuscitation After Traumatic Cardiac Arrest in Swine

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Jiefeng Xu ◽  
Peng Shen ◽  
Senlin Xia ◽  
Yuzhi Gao ◽  
Shaoyun Liu ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cerebral Perfusion ◽  
Coronary Perfusion Pressure ◽  
Balloon Occlusion ◽  
Control Group ◽  
Swine Model ◽  
Coronary Perfusion ◽  
Traumatic Cardiac Arrest ◽  
Aortic Balloon Occlusion

Introduction: Following hemorrhage-induced traumatic cardiac arrest (TCA), the effectiveness of standard cardiopulmonary resuscitation (CPR) would be weakened or lost due to an inadequate circulating volume. Previous investigations demonstrated that aortic balloon occlusion (ABO) could control the bleeding and increase proximal organ perfusion during severe traumatic hemorrhage. In this study, we investigated the effect of ABO on the efficacy of CPR in a swine model of TCA. Hypothesis: ABO initiated during CPR would increase cardiac and cerebral perfusion so as to improve the outcomes of resuscitation after TCA in swine. Methods: Twenty-seven male domestic swine weighing 33±4 kg were utilized. Forty percent of estimated blood volume was removed within 20 mins. The animals were then subjected to 5 mins of untreated ventricular fibrillation and 5 mins of CPR. Coincident with the start of CPR, the animals were randomized to receive ABO (n=15) or control (n=12). Meanwhile, normal saline was intravenously infused at a speed of 0.7 ml/kg/min in all animals. Results: During CPR, significantly greater coronary perfusion pressure, regional cerebral oxygen saturation and end-tidal CO 2 were observed in animals treated with ABO when compared with the control group (Table). Consequently, the rate of resuscitation success was significantly higher in the ABO group than in the control group (15/15 vs. 9/12, p = 0.040). Additionally, shorter duration of CPR (5.1±0.5 vs. 7.5±4.5 min, p = 0.054) and less number of shocks (1.1±0.3 vs. 2.0±1.8, p = 0.058) were required for establishing spontaneous circulation in the ABO group compared to the control group. Conclusion: The implementation of ABO during CPR significantly increased cardiac and cerebral perfusion and improved the outcomes of resuscitation in TCA following massive hemorrhage.

Calcium-entry blockers during porcine cardiopulmonary resuscitation

1990 ◽  
Vol 78 (2) ◽  
pp. 207-213 ◽  
Author(s):  
Martin von Planta ◽  
Max Harry Weil ◽  
Raul J. Gazmuri ◽  
Marc A. Ritz ◽  
Eric C. Rackow
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Co2 Concentration ◽  
Coronary Perfusion Pressure ◽  
Calcium Entry ◽  
Coronary Perfusion ◽  
Calcium Entry Blockers ◽  
Coronary Vein ◽  
End Tidal ◽  
Canine Myocardium

1. Calcium-entry blockers increase the intramyo-cardial pH and decrease the intramyocardial Pco2 of ischaemic canine myocardium. However, the evidence documenting improvements in myocardial acidosis and in myocardial resuscitability after administration of calcium-entry blockers during cardiac arrest is incomplete. We therefore compared the effects of verapamil (0.05 mg/kg) and diltiazem (0.075 mg/kg) with those of saline placebo in an established porcine model of cardiac arrest and cardiopulmonary resuscitation. 2. After verapamil, six of 11 animals were successfully resuscitated; after diltiazem, five of 10; and after saline placebo, six of 10. Coronary perfusion and mean aortic pressures together with end-tidal CO2 concentration during precordial compression were predictive of resuscitation, independently of the drug or placebo. 3. Coronary vein pH decreased to 6.91 ± 0.06 units (mean ± sem) with concurrent increases in Pco2 to levels exceeding 100 mmHg. Coronary vein lactate increased to a maximum of 7.5 ± 0.6 mmol/l. Coronary vein acidaemia was accompanied by decreases in intramyocardial pH to 6.64 ± 0.06 units. However, each of these differences between success and failure of resuscitation was unrelated to treatment with calcium-entry blockers. 4. Accordingly, neither verapamil nor diltiazem selectively altered coronary perfusion pressure, attenuated intramyocardial acidosis or improved resuscitability after porcine cardiac arrest and cardiopulmonary resuscitation.

scholarly journals Does ‘heads-up’ cardiopulmonary resuscitation improve outcomes for patients in out-of-hospital cardiac arrest? A systematic review

2020 ◽  
Vol 4 (4) ◽  
pp. 16-24
Author(s):  
Andrew Elphinstone ◽  
Samantha Laws
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Animal Studies ◽  
Life Support ◽  
Survival Rates ◽  
Advanced Life Support ◽  
Coronary Perfusion Pressure ◽  
Coronary Perfusion ◽  
Hospital Cardiac Arrest

Introduction: Survival rates for patients in out-of-hospital cardiac arrest have remained around 10% in the United Kingdom for the past seven years. If outcomes are to be improved, research into new methods of advanced life support is required. One such method may be ‘heads-up’ cardiopulmonary resuscitation.Methods: A systematic review of literature exploring heads-up cardiopulmonary resuscitation was conducted in an attempt to identify its effects on survival to discharge and neurological outcome.Results: A comprehensive search of CINAHL, MEDLINE and Google Scholar was undertaken. Six papers were classed as sufficiently relevant for inclusion. Included studies were generally of low quality and none studied the effect of heads-up cardiopulmonary resuscitation on out-of-hospital cardiac arrest patients. Animal studies identified a significant reduction in intracranial pressure and increase in cerebral and coronary perfusion pressure for use of augmented heads-up cardiopulmonary resuscitation in the porcine model of cardiac arrest.Conclusion: Further research is required to analyse the effects and potential benefits of augmented heads-up cardiopulmonary resuscitation in out-of-hospital cardiac arrest.

Endobronchial Vasopressin Improves Survival during Cardiopulmonary Resuscitation in Pigs 

1997 ◽  
Vol 86 (6) ◽  
pp. 1375-1381 ◽  
Author(s):  
Volker Wenzel ◽  
Karl H. Lindner ◽  
Andreas W. Prengel ◽  
Keith G. Lurie ◽  
Hans U. Strohmenger
Keyword(s):  
Placebo Group ◽  
Cardiopulmonary Resuscitation ◽  
Drug Administration ◽  
Porcine Model ◽  
Perfusion Pressure ◽  
Coronary Perfusion Pressure ◽  
Spontaneous Circulation ◽  
Coronary Perfusion ◽  
Successful Resuscitation ◽  
Short Period

Background Intravenous administration of vasopressin during cardiopulmonary resuscitation (CPR) has been shown to be more effective than optimal doses of epinephrine. This study evaluated the effect of endobronchial vasopressin during CPR. Methods After 4 min of untreated ventricular fibrillation and 3 min of CPR, 21 pigs were randomized to be treated with 0.8 U/kg intravenous vasopressin (n = 7), 0.8 U/kg endobronchial vasopressin (n = 9), or an endobronchial placebo of normal saline (n = 5). Defibrillation was performed 5 min after drug administration to attempt return of spontaneous circulation. Results All animals in the intravenous and endobronchial vasopressin group were resuscitated successfully, but only two of five animals in the placebo group were. At 2 and 5 min after drug administration, coronary perfusion pressure in the intravenous and endobronchial vasopressin group was significantly higher than in the placebo group (50 +/- 10, 34 +/- 5 vs. 16 +/- 6 mmHg, respectively; and 35 +/- 10, 39 +/- 10 vs. 19 +/- 5 mmHg, respectively; P < 0.05). Conclusions Endobronchial vasopressin is absorbed during CPR, coronary perfusion pressure is increased significantly within a short period, and the chance of successful resuscitation is increased in this porcine model of CPR. Endobronchial vasopressin may be an alternative for vasopressor administration during CPR, when intravenous access is delayed or not available.

Abstract 152: Intrinsic Vascular Tone may be Necessary for Successful Resuscitation from Experimental Cardiac Arrest

2013 ◽  
Vol 113 (suppl_1) ◽  
Author(s):  
Andrew Ramadeen ◽  
Gerhard Dashi ◽  
Xudong Hu ◽  
Albert K Tsui ◽  
Lily Zou ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Minute Ventilation ◽  
Survival Rates ◽  
Systolic Pressure ◽  
Intrathoracic Pressure ◽  
Brain Perfusion ◽  
Coronary Perfusion Pressure ◽  
Left Ventricular ◽  
Coronary Perfusion ◽  
Successful Resuscitation

Introduction: Survival rates from out-of-hospital cardiac arrest are often <10% despite performance of good quality CPR. We assessed the hypothesis that the effect of CPR on cardiac and brain perfusion may be dependent on factors other than thoracic compression force and ventilation. Methods: Eighty healthy Yorkshire pigs (29±3 kg) were anesthetized and underwent 2-4 minutes of untreated ventricular fibrillation (VF), followed by guideline based CPR, then defibrillation. “Survivors” were pigs in sinus rhythm with aortic systolic pressure ≥30 mmHg 30 minutes after defibrillation; all others were “non-survivors”. Hemodynamic, ventilatory and defibrillation parameters were measured and tested for association with survival. Results: Thirty four pigs survived (43%). During baseline and untreated VF, hemodynamic and blood gas parameters were not different between survivors and non-survivors. During CPR, compressions generated adequate left ventricular pressures in both groups (99±21 mmHg vs. 106±28 mmHg, survivors vs. non-survivors, P=ns). Compressions produced 28% higher peak aortic pressures in survivors than non-survivors (respectively 73±21 mmHg vs. 57±17 mmHg, P<0.005). During the decompression phase, nadir aortic pressures were 41% higher in survivors than non-survivors (respectively 24±7 mmHg vs. 17±5 mmHg, P<0.0001). Controlled manual bag ventilation during CPR resulted in significantly higher minute ventilation being delivered to survivors compared to non-survivors (4.8±2.3 L/min vs. 3.9±1.4 L/min, P<0.05). Coronary perfusion pressure, carotid blood flow, cerebral O 2 tension, and end tidal CO 2 were also higher in survivors. Conclusions: Guideline based CPR in a uniform population of pigs undergoing a structured cardiac arrest and resuscitation protocol does not produce consistent results. Intravascular pressures, intrathoracic pressure and critical organ flow correlate with survival. During cardiac arrest, more emphasis may need to be placed on vascular support rather than powerful compressions.

Abstract 215: Hemodynamics of Absolute, Proportional, and Adaptive Mechanical Chest Compression Strategies in a Swine Model of Pediatric Out-Of-Hospital Cardiac Arrest

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
David D Salcido ◽  
Allison C Koller ◽  
Cornelia Genbrugge ◽  
Caelie Kern ◽  
James J Menegazzi
Keyword(s):  
Cardiac Arrest ◽  
Pressure Sensors ◽  
Adaptive Strategy ◽  
Coronary Perfusion Pressure ◽  
Right Atrial ◽  
Swine Model ◽  
Coronary Perfusion ◽  
Supporting Evidence ◽  
Pediatric Resuscitation ◽  
The Right

Background: Guidelines for pediatric resuscitation recommend a depth of 1.5in or 1/3 anterior-posterior chest diameter for chest compressions (CC) despite little supporting evidence. Objective: To evaluate the hemodynamic effects of the two recommended depths and an adaptive strategy. Methods: Thirty-eight animals (mass ~25kg) were sedated, anesthetized, intubated, and ventilated. Micromanometer pressure sensors were installed in the aorta and right atrium via the right femoral artery and vein. Coronary perfusion pressure (CPP) was calculated as aortic minus right atrial pressure. An ultrasonic flow probe was secured around the right common carotid. Biosignals were recorded at 1000Hz. Animals were then re-paralyzed, followed by a fentanyl bolus, and the endotracheal tube was occluded for 9min. Each was randomized to absolute (Group 1: 1.5in & 100/min), proportional (Group 2: 1/3 AP diameter & 100/min), or stepwise adaptive (Group 3: 1.5in & 100/min, adding 0.25in or 5/min q25s until CPP > 25mmHg) CC using a robotic compressor. Epinephrine (0.1mg/kg) and sodium bicarbonate (1mEq/kg) were given after 4min, followed by epinephrine (0.15mg/kg) q3min. Defibrillation (150J) was attempted after 5min; CPR discontinued after 20min. Mean arterial pressure (MAP), CPP and carotid blood flow (CBF) were calculated for the first 10 minutes of CPR and compared between groups with generalized estimating equations (GEE). Results: In GEE models, MAP, CBF and CPP did not differ between groups over the first 10 minutes of resuscitation. Each measure differed significantly over time (p<0.05). When considering only the first 5 minutes (early phase including first pressor), hemodynamic variables also did not differ. Conclusion: In a swine model of asphyxial cardiac arrest, CC methods based on current guidelines and an additional adaptive approach did not differ hemodynamically.

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