Abstract 80: Development of CA1 Damage: Different Cell Counts in CA1 Region of Rats Resuscitated from 8-Minute Ventricular Fibrillation Cardiac Arrest After 2 Weeks of Survival Compared with 20 Weeks of Survival

Background: Rodent models of cardiac arrest (CA) help to investigate mechanisms and therapy of cerebral ischemia and reperfusion. The CA1 region of hippocampus is specifically vulnerable to global ischemia and is considered to play an important role in neurological deficits of patients surviving cardiac arrests. Methods: Male 350g Sprague-Dawley rats were put into ventricular fibrillation (VF) CA. After 8 min of CA the animals received mechanical chest compressions for 2 min and epinephrine 20 μg/kg. The animals were defibrillated thereafter every 2 min to achieve return of spontaneous circulation. Six animals surviving with favorable neurologic recovery were sacrificed after 2 weeks and 11 after 20 and compared to 4 sham rats. For histological examination brains were fixed in formalin, paraffin-embedded and cut into coronary sections of 3 μm thickness. In Hematoxylin- Eosin-stained sections viable neurons were counted in a 500 μm sector of the CA1 region. Results: In sham animals 84±12 viable cells were counted in CA1 region. Two week survivors had 16±8 cells (p< 0.001), whereas 20 week survivors had 37±31 (p=0.018 vs sham, p=0.084 vs 2 weeks survivors) cells. The latter showed in 7 animals many viable cells (60±15) compared to 2 weeks survivors and in 4 animals very few cells 4±3 cells. Conclusions: A repopulation within week 2 and 20 of pyramid cells in the CA1 region of the hippocampus seems to have taken place in 7 of 11 rats resuscitated from 8 min VFCA whereas in others not. To discover the mechanism responsible for this huge difference in cell counts of the CA1 region in long time survivors of CA might help to understand the pathological mechanisms of the global ischemic insult.

Download Full-text

D-Cycloserine 24 and 48 Hours after Asphyxial Cardiac Arrest has No Effect on Hippocampal CA1 Neuropathology

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/jcbfm.2014.135 ◽

2014 ◽

Vol 34 (10) ◽

pp. e1-e8 ◽

Cited By ~ 1

Author(s):

Vélvá M Combs ◽

Heather D Crispell ◽

Kelly L Drew

Keyword(s):

Cardiac Arrest ◽

Closed Head Injury ◽

Spontaneous Circulation ◽

Neurological Deficits ◽

Sprague Dawley ◽

Cell Counts ◽

Sprague Dawley Rats ◽

Hippocampal Ca1 ◽

Asphyxial Cardiac Arrest ◽

Stimulation Of

Stimulation of N-methyl-D-aspartate receptors (NMDAR) contributes to regenerative neuroplasticity following the initial excitotoxic insult during cerebral ischemia. Stimulation of NMDAR with the partial NMDAR agonist D-cycloserine (DCS) improves outcome and restores hippocampal synaptic plasticity in models of closed head injury. We thus hypothesized that DCS would improve outcome following restoration of spontaneous circulation (ROSC) from cardiac arrest (CA). DCS (10 mg/kg, IP) was administered to Sprague-Dawley rats (male, 250–330 g; 63–84 days old) 24 and 48 hours after 6 or 8 minutes of asphyxial CA. Heart rate and blood pressure declined similarly in all groups. Animals showed neurological deficits after 6 and 8 minutes CA ( P < 0.05, Tukey) and these deficits recovered more quickly after 6 minutes than after 8 minutes of CA. CA decreased the number of healthy neurons within CA1 with no difference between 6 and 8 minutes duration of CA (180.8 ± 27.6 (naïve, n = 5) versus 46.3 ± 33.8 (all CA groups, n = 27) neurons per mm CA1). DCS had no effect on neurological deficits or CA1 hippocampal cell counts ( P > 0.05, Tukey).

Download Full-text

Abstract 15: Repopulation of CA1 Region in the Hippocampus is Accompanied by Increased Diameter and Reduced Glial Scarring After 20 Weeks of Survival in an 8 Min Ventricular Fibrillation Cardiac Arrest Rat Model

Circulation ◽

10.1161/circ.138.suppl_2.15 ◽

2018 ◽

Vol 138 (Suppl_2) ◽

Author(s):

Wolfgang Weihs ◽

Florian Ettl ◽

Ingrid A Magnet ◽

Alexandra M Warenits ◽

Harald Herkner ◽

...

Keyword(s):

Cardiac Arrest ◽

Ventricular Fibrillation ◽

Rat Model ◽

Neuronal Damage ◽

Late Phase ◽

Therapeutic Window ◽

Sprague Dawley ◽

Term Survival ◽

Neurologic Recovery ◽

Ca1 Region

Background: The CA1 region of hippocampus is specifically vulnerable to global ischemia and is depopulated 14 days after 8min ventricular fibrillation cardiac arrests (VF-CA) and conventional resuscitation in a rat model. We have previously reported on the pyramidal cell repopulation of the CA1 region after long term survival after cardiac arrest in two thirds of animals. (Circulation. 2014;130:A80) The aim of this study was to investigate the distribution of microglia and astrocytes in the CA1 region of rat hippocampus after CA and to measure its diameter. Methods: After 8 min of VF-CA male Sprague-Dawley rats received mechanical chest compressions for 2 min and epinephrine 20 μg/kg. The animals were defibrillated thereafter every 2 min to achieve return of spontaneous circulation. Animals surviving with favorable neurologic recovery were sacrificed 140 days after CA (n=12, 8 with neuronal repopulation (R), 4 without R (nonR)) and compared to 14 day survivors (n=6) and control animals (n=20). Results: Microglia cells/ 75000μm 2 were 6±3 in controls, 53±9 in 14d survivors (p<0.001 vs controls), 12±4 in 140d-R and 19±12 in 140d-nonR. Astrocytes/75000μm 2 were 9±2 in controls, 15±3 in 14d survivors (p<0.001 vs controls), 21±4 in 140d-R and 43±13 in 140d-nonR animals (p<0.001 vs 140d-R). The hippocampal diameter (μm) was 543±36 in controls, 417±36 in 14d survivors (p<0.001 vs controls), 462±39 in 140d-R and 306±86 in 140d-nonR animals (p<0.001 vs 140d-R). Conclusions: The repopulation of pyramid cells in the CA1 that has taken place in two thirds of animals is accompanied by a significant increase in the diameter of the hippocampus and reduced astrocyte numbers compared to nonR-animals. Numbers of microglial cells are significantly increased after 14d survival removing cell debris after neuronal damage. This lifelong potential of the hippocampus for repair due to adult neurogenesis may open an additional late phase therapeutic window for CA recovery.

Download Full-text

Abstract 211: Delayed Cell Death in CA1 Region in a Cardiac Arrest Rat Model: Continuing After 2 Weeks of Survival?

Circulation ◽

10.1161/circ.130.suppl_2.211 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Sandra Högler ◽

Ursula Teubenbacher ◽

Wolfgang Weihs ◽

Fritz Sterz ◽

Ingrid A M Magnet ◽

...

Keyword(s):

Cell Death ◽

Cardiac Arrest ◽

Brain Regions ◽

Spontaneous Circulation ◽

Sprague Dawley ◽

Ca1 Region ◽

Delayed Cell Death ◽

Time Period ◽

Sprague Dawley Rats ◽

Hematoxylin Eosin

Background: Evolution of histological lesions in selectively vulnerable brain regions in animal models of cardiac arrest (CA)give evidence of potential therapeutic windows. Delayed cell death is of special interest in this regard. Methods: In male Sprague-Dawley rats (350g) ventricular fibrillation (VF) CA was induced for 6 min followed by chest compressions, ventilation and drugs for 2 min. To achieve return of spontaneous circulation animals were defibrillated every 2 min. Animals were sacrificed after one week (n=5) or two weeks (n=7) of survival and compared to four sham animals. Brains were fixed in formalin, embedded in paraffin wax and cut into 3 μm thick coronary sections for histological examination. Viable neurons with nucleolus were counted in Hematoxylin-Eosin (HE)-stained sections in a 250 μm sector of the medial CA1 region. FluoroJade B staining was applied to count dying neurons in the same sector. Results: In HE-staining sham animals had 31±4 viable neurons. In one week survivors 11±9 viable neurons (p=0.003) and in two week survivors 7±7 viable neurons (p=0.001 vs sham, p=0.49 vs one week survivors) were counted. Furthermore, a lot of degenerated hypereosinophilic neurons were present in HE-staining in both CA-groups. FluoroJade B-staining was negative in sham animals. In one week survivors 29±8 dying neurons (p=0.006) and in two week survivors 33±13 dying neurons (p= 0.016 vs sham, p=0.343 vs one week survivors) were detectable. Conclusions: Consistent damage in the medial CA1 region was present after 6 min VFCA in both survival time groups. Lesions seemed to be constant, with no significant differences between time points. Contrary to expectations, FluoroJade B-staining was still positive after two weeks of survival, suggesting that delayed cell death might go on for a longer time period than assumed so far.

Download Full-text

Protective head-cooling during cardiac arrest and cardiopulmonary resuscitation: the original animal studies

Neurology International ◽

10.4081/ni.2010.e3 ◽

2010 ◽

Vol 2 (1) ◽

pp. 3 ◽

Cited By ~ 1

Author(s):

Eric W. Brader ◽

Dietrich Jehle ◽

Michael Mineo ◽

Peter Safar

Keyword(s):

Cardiac Arrest ◽

Ventricular Fibrillation ◽

Cardiopulmonary Resuscitation ◽

Hospital Setting ◽

Treated Group ◽

Spontaneous Circulation ◽

Neurological Deficits ◽

Control Group ◽

Surface Cooling ◽

Head Cooling

Prolonged standard cardiopulmonary resuscitation (CPR) does not reliably sustain brain viability during cardiac arrest. Pre-hospital adjuncts to standard CPR are needed in order to improve outcomes. A preliminary dog study demonstrated that surface cooling of the head during arrest and CPR can achieve protective levels of brain hypothermia (30°C) within 10 minutes. We hypothesized that protective head-cooling during cardiac arrest and CPR improves neurological outcomes. Twelve dogs under light ketamine-halothane-nitrous oxide anesthesia were arrested by transthoracic fibrillation. The treated group consisted of six dogs whose shaven heads were moistened with saline and packed in ice immediately after confirmation of ventricular fibrillation. Six control dogs remained at room temperature. All 12 dogs were subjected to four minutes of ventricular fibrillation and 20 minutes of standard CPR. Spontaneous circulation was restored with drugs and countershocks. Intensive care was provided for five hours post-arrest and the animals were observed for 24 hours. In both groups, five of the six dogs had spontaneous circulation restored. After three hours, mean neurological deficit was significantly lower in the treated group (P=0.016, with head-cooled dogs averaging 37% and the normothermic dogs 62%). Two of the six head-cooled dogs survived 24 hours with neurological deficits of 9% and 0%, respectively. None of the control group dogs survived 24 hours. We concluded that head-cooling attenuates brain injury during cardiac arrest with prolonged CPR. We review the literature related to the use of hypothermia following cardiac arrest and discuss some promising approaches for the pre-hospital setting.

Download Full-text

Effects of the duration of postresuscitation hyperoxic ventilation on neurological outcome and survival in an asphyxial cardiac arrest rat model

Scientific Reports ◽

10.1038/s41598-019-52477-y ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Tongyi Hu ◽

Jianjie Wang ◽

Shuangwei Wang ◽

Jingru Li ◽

Bihua Chen ◽

...

Keyword(s):

Cardiac Arrest ◽

Survival Rates ◽

Spontaneous Circulation ◽

Temperature Management ◽

Sprague Dawley ◽

High Concentration ◽

Neurologic Recovery ◽

Physiological Variables ◽

Hyperoxic Ventilation ◽

Asphyxial Cardiac Arrest

Abstract Cardiac arrest leads to sudden cessation of oxygen supply and cerebral hypoxia occurs when there is not sufficient oxygen supplied to the brain. Current Guidelines for adult cardiopulmonary resuscitation (CPR) and emergency cardiovascular care recommend the use of 100% oxygen during resuscitative efforts to maximize the probability of achieving the return of spontaneous circulation (ROSC). However, the optimal strategy for oxygen management after ROSC is still debatable. The aim of the present study was to evaluate the effects of the duration of post-resuscitation hyperoxic ventilation on neurological outcomes in asphyxial cardiac arrest rats treated with targeted temperature management (TTM). Asphyxia was induced by blocking the endotracheal tube in 80 adult male Sprague-Dawley rats. CPR begun after 7 min of untreated cardiac arrest. Animals were randomized to either the normoxic control under normothermia (NNC) group or to one of the 4 experimental groups (n = 16 each) immediately after ROSC: ventilated with 100% oxygen for 0 (O2_0h), 1 (O2_1h), 3 (O2_3h), or 5 (O2_5h) h and ventilated with room air thereafter under TTM. Physiological variables were recorded at baseline and during the 6 h postresuscitation monitoring period. Animals were closely observed for 96 h to assess neurologic recovery and survival. There were no significant differences in baseline measurements between groups, and all animals were successfully resuscitated. There were significant interactions between the duration of 100% oxygen administration and hemodynamics as well as, myocardial and cerebral injuries. Among all the durations of hyperoxic ventilation investigated, significantly lower neurological deficit scores and higher survival rates were observed in the O2_3h group than in the NNC group. In conclusion, postresuscitation hyperoxic ventilation leads to improved PaO2, PaCO2, hemodynamic, myocardial and cerebral recovery in asphyxial cardiac arrest rats treated with TTM. However, the beneficial effects of high concentration-oxygen are duration dependent and ventilation with 100% oxygen during induced hypothermia contributes to improved neurological recovery and survival after 96 h.

Download Full-text

Abstract 17847: Gasping is a Valid Predictor Of ROSC and Hospital Discharge for In-hospital Cardiac Arrest Occurring on the Ward

Circulation ◽

10.1161/circ.132.suppl_3.17847 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Luca Marengo ◽

Wolfgang Ummenhofer ◽

Gerster Pascal ◽

Falko Harm ◽

Marc Lüthy ◽

...

Keyword(s):

Cardiac Arrest ◽

Ventricular Fibrillation ◽

Hospital Discharge ◽

Survival Data ◽

Neurological Outcome ◽

Rapid Response Team ◽

Spontaneous Circulation ◽

University Hospital ◽

Data Set ◽

Hospital Cardiac Arrest

Introduction: Agonal respiration has been shown to be commonly associated with witnessed events, ventricular fibrillation, and increased survival during out-of-hospital cardiac arrest. There is little information on incidence of gasping for in-hospital cardiac arrest (IHCA). Our “Rapid Response Team” (RRT) missions were monitored between December 2010 and March 2015, and the prevalence of gasping and survival data for IHCA were investigated. Methods: A standardized extended in-hospital Utstein data set of all RRT-interventions occurring at the University Hospital Basel, Switzerland, from December 13, 2010 until March 31, 2015 was consecutively collected and recorded in Microsoft Excel (Microsoft Corp., USA). Data were analyzed using IBM SPSS Statistics 22.0 (IBM Corp., USA), and are presented as descriptive statistics. Results: The RRT was activated for 636 patients, with 459 having a life-threatening status (72%; 33 missing). 270 patients (59%) suffered IHCA. Ventricular fibrillation or pulseless ventricular tachycardia occurred in 42 patients (16% of CA) and were associated with improved return of spontaneous circulation (ROSC) (36 (97%) vs. 143 (67%; p<0.001)), hospital discharge (25 (68%) vs. 48 (23%; p<0.001)), and discharge with good neurological outcome (Cerebral Performance Categories of 1 or 2 (CPC) (21 (55%) vs. 41 (19%; p<0.001)). Gasping was seen in 128 patients (57% of CA; 46 missing) and was associated with an overall improved ROSC (99 (78%) vs. 55 (59%; p=0.003)). In CAs occurring on the ward (154, 57% of all CAs), gasping was associated with a higher proportion of shockable rhythms (11 (16%) vs. 2 (3%; p=0.019)), improved ROSC (62 (90%) vs. 34 (55%; p<0.001)), and hospital discharge (21 (32%) vs. 7 (11%; p=0.006)). Gasping was not associated with neurological outcome. Conclusions: Gasping was frequently observed accompanying IHCA. The faster in-hospital patient access is probably the reason for the higher prevalence compared to the prehospital setting. For CA on the ward without continuous monitoring, gasping correlates with increased shockable rhythms, ROSC, and hospital discharge.

Download Full-text

Abstract 56: Ventilation Is Necessary During Cardiopulmonary Resuscitation In A Rat Model Of Cardiac Arrest Induced By Airway Obstruction

Circulation ◽

10.1161/circ.116.suppl_16.ii_935 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Akihide Kurita ◽

Takumi Taniguchi ◽

Ken Yamamoto

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Airway Obstruction ◽

Survival Rates ◽

Spontaneous Circulation ◽

Sprague Dawley ◽

Plasma Cytokine ◽

Sprague Dawley Rats ◽

Ventilation Strategies ◽

Lactate Levels

Recent studies have showed that hypoventilation during cardiopulmonary resuscitation (CPR) improved the rates of return of spontaneous circulation (ROSC) and prognosis. However, there are few studies about the ventilation strategies during CPR in cardiac arrest caused by airway obstruction. To compare the effects of the three ventilation strategies during CPR in an animal model of cardiac arrest induced by airway obstruction, we investigated the rates of ROSC, survival rates, plasma cytokine levels, and lactate levels. thirty-six male Sprague Dawley rats were anesthetized with intraperitoneal injection of pentobarbital. Cardiac arrest was induced by airway obstruction. After 3 minutes of cardiac arrest, animals were randomized to receive one of the three ventilation strategies during CPR (n = 12 per group): normoventiraion (28 breaths/min), hypoventilation (14 breaths/min), or no-ventilation. The rates of chest compression (CC) was 240 –260 compressions/min and the depth of CC adjusted to maintain mean arterial pressure more than 25 mmHg in all groups. After 5 minutes of CPR, epinephrine (0.02 mg/kg) was administered, and all rats were ventilated at the rates of 28 breaths/min in FiO2 1.0. The rates of ROSC were 83%, 58%, 0% for the normoventilation, hypoventilation, and no-ventilation groups, respectively. The PaCO2 levels immediately after ROSC were 74mmHg and 88 mmHg for the normoventilation, and hypoventilation groups, respectively. The increases of plasma cytokine (TNF-a, and IL-6) levels and lactate levels after ROSC in the normoventilation group were significantly less than those in the hypoventilation group. The present study showed that normoventilation during CPR improved the rates of ROSC and the survival rates after ROSC in the animal cardiac arrest model induced by airway obstruction. Moreover, normoventilation attenuated the elevation of cytokine and lactate responses. These findings suggest that ventilation may be necessary during CPR in cardiac arrest caused by airway obstruction.

Download Full-text

Expression of Glucocorticoid Receptors in the Early Period After the Return of Spontaneous Circulation Among Patients Who Experienced Cardiac Arrest : A Retrospective Observational Study

10.21203/rs.3.rs-278830/v1 ◽

2021 ◽

Author(s):

Yanan Yu ◽

Ziren Tang ◽

Jiabao Li ◽

Miaorong Xie ◽

Chenchen Hang ◽

...

Keyword(s):

Cardiac Arrest ◽

Glucocorticoid Receptors ◽

Early Period ◽

Treg Cells ◽

Spontaneous Circulation ◽

Skewed Distribution ◽

Control Group ◽

Total Cortisol ◽

Cell Counts ◽

Healthy Control

Abstract Background: Rapid changes in glucocorticoid (GC) levels and adrenal insufficiency are related to the development of post-cardiac arrest syndrome. However, changes in glucocorticoid receptors (GR) have not been studied. Hence, this study aimed to investigate the association of early changes in GR and prognosis and immune response in patients who experienced cardiac arrest (CA). Methods: In this observational single-center case-control study, we enrolled patients who were in the early period of return of spontaneous circulation after CA and were admitted to the emergency department of the Beijing Chaoyang Hospital between October 2018 and October 2019. Age- and sex-matched healthy individuals were recruited for the control group after a physical examination.GR expression and cell counts of circulatory T and B lymphocytes, natural killer, and regulatory T (Treg) cells were assessed. Plasma total cortisol and adrenocorticotrophic hormone (ACTH) levels were tested. Since the data for total cortisol and ACTH levels had a skewed distribution, we compared our results with the natural logarithmic conversion values after adding 1 (ln [total cortisol+ 1], ln [ACTH+ 1]). Measurement data with a skewed distribution are expressed as medians (25th and 75th percentiles). The Mann–Whitney U test was used to compare variables between groups. The qualitative parameters in the 2 × 2 contingency table were used for analysis.Results: Overall, 85 patients who experienced CA and 40 healthy individuals were enrolled. All cell counts were lower and plasma total cortisol levels were higher (P<0.001) in patients who experienced CA than those in the healthy control group. GR expression in Treg cells and CD3+CD4+ T lymphocytes was not significantly different, but the mean fluorescence intensity and GR expression in other cells were lower in patients who experienced CA (P<0.05) than those in the healthy control group. ACTH levels did not show any difference. There were no significant differences between survivors and non-survivors. Conclusion: Our findings provide insights into GC sensitivity and immunosuppressive status in these patients, and a new perspective for GC targeted treatment.

Download Full-text

Abstract 148: Zoniporide Combined with α-Methylnorepinephrine Appears Highly Effective for Resuscitation from Cardiac Arrest in a Rat Model of Ventricular Fibrillation

Circulation ◽

10.1161/circ.130.suppl_2.148 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Lorissa Lamoureux ◽

Herbert K Whitehouse ◽

Jeejabai Radhakrishnan ◽

Raúl J Gazmuri

Keyword(s):

Cardiac Arrest ◽

Chest Compression ◽

Rat Model ◽

Myocardial Dysfunction ◽

Spontaneous Circulation ◽

Sprague Dawley ◽

Survival Times ◽

Highly Effective ◽

Electrical Shocks ◽

Novel Strategy

Background: We have reported in rat and swine models of cardiac arrest that sodium hydrogen exchanger isoform-1 (NHE-1) inhibition facilitates resuscitation, ameliorates myocardial dysfunction, and improves survival. Others have reported that α-methylnorepinephrine (α-MNE) - a selective α2-adrenoreceptor agonist - is superior to epinephrine given its lack of β-agonist effects. We examined in a rat model of VF and closed-chest resuscitation the effects of combining the NHE-1 inhibitor zoniporide (ZNP) with α-MNE. Methods: VF was electrically induced in 32 male retired breeder Sprague-Dawley rats and left untreated for 8 minutes after which resuscitation was attempted by an 8 minute interval of chest compression and delivery of electrical shocks. Rats were randomized 1:1:1:1 to receive a 3 mg/kg bolus of ZNP or 0.9% NaCl before starting chest compression and a 100 μg/kg bolus of α-MNE or its vehicle at minute 2 of chest-compressions establishing 4 groups of 8 rats each. Successfully resuscitated rats were monitored for 240 minutes. Results: The number of rats that had return of spontaneous circulation and then survived 240 min were: α-MNE(-)/ZNP(-) 4 and 2; α-MNE(-)/ZNP(+) 5 and 5; α-MNE(+)/ZNP(-) 2 and 1; and α-MNE(+)/ZNP(+) 7 and 7 yielding a statistically significant effect on overall survival times corresponding to 105 ± 114, 150 ± 124, 58 ± 108, and 210 ± 85 min, respectively (p < 0.045). Post-resuscitation lactate levels were attenuated in all treatment groups with the greatest effect by the α-MNE(+)/ZNP(+) combination without major differences in hemodynamic function (Table). Conclusion: We confirm a beneficial effect resulting from the combination of ZNP (given to attenuate myocardial reperfusion injury) and α-MNE (given to augment peripheral vascular resistance during chest compression without the detrimental actions of epinephrine). The proposed combination may prove to be a highly effective novel strategy for resuscitation from cardiac arrest.

Download Full-text

The dependence of successful resuscitation on electrocardiographically documented cardiac rhythm in case of out-of-hospital cardiac arrest

Medicina ◽

10.3390/medicina43100102 ◽

2007 ◽

Vol 43 (10) ◽

pp. 798 ◽

Cited By ~ 4

Author(s):

Nedas Jasinskas ◽

Dinas Vaitkaitis ◽

Vidas Pilvinis ◽

Lina Jančaitytė ◽

Gailutė Bernotienė ◽

...

Keyword(s):

Cardiac Arrest ◽

Ventricular Fibrillation ◽

Cardiac Rhythm ◽

Sudden Cardiac Arrest ◽

Spontaneous Circulation ◽

Consensus Conference ◽

Successful Resuscitation ◽

Initial Rhythm ◽

Hospital Deaths ◽

One Year

Objective. To determine the influence of electrocardiographically documented cardiac rhythm during sudden cardiac arrest on successful resuscitation among out-of-hospital deaths in Kaunas city. Material and methods. An observational prospective study was conducted between 1 January, 2005, and 30 December, 2005, in Kaunas city with a population of 360 627 inhabitants. In this period, all cases of cardiac arrest were analyzed according to the guidelines of the Utstein consensus conference. Cardiac arrest (both of cardiac and noncardiac etiology) was confirmed in 72 patients during one year. Effective cardiopulmonary resuscitation was performed in 18 patients. Results. The total number of deaths from all causes in Kaunas during 1-year study period was 6691. Sixty-two patients due to sudden death of cardiac etiology were resuscitated by emergency medical services personnel. Return of spontaneous circulation was achieved in 11 patients. Ventricular fibrillation was observed in 33 (53.2%) patients. Asystole was present in 11 (17.7%) and other rhythms in 18 (29.1%) cases. Patients with ventricular fibrillation as an initial rhythm were more likely to be successfully resuscitated than patients with asystole. Conclusions. Ventricular fibrillation was the most common electrocardiographically documented cardiac rhythm registered during cardiac arrest in out-of-hospital settings. Ventricular fibrillation as a mechanism of cardiac arrest was associated with major cases of successful resuscitation.

Download Full-text