Document Detail


Anaesthetic Postconditioning at the Initiation of CPR Improves Myocardial and Mitochondrial Function in a Pig Model of Prolonged Untreated Ventricular Fibrillation.
MedLine Citation:
PMID:  25281906     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Anaesthetic postconditioning (APoC) attenuates myocardial injury following coronary ischaemia/reperfusion. We hypothesised that APoC at the initiation of cardiopulmonary resuscitation (CPR) will improve post resuscitation myocardial function along with improved mitochondrial function in a pig model of prolonged untreated ventricular fibrillation.
METHODS: In 32 pigs isoflurane anaesthesia was discontinued prior to induction of ventricular fibrillation that was left untreated for 15min. At the initiation of CPR, 15 animals were randomised to controls (CON), and 17 to APoC with 2vol% sevoflurane during the first 3min CPR. Pigs were defibrillated after 4min of CPR. After return of spontaneous circulation (ROSC), isoflurane was restarted at 0.8-1.5vol% in both groups. Systolic and diastolic blood pressures were measured continuously. Of the animals that achieved ROSC, eight CON and eight APoC animals were randomised to have their left ventricular ejection fraction (LVEF%) assessed by echocardiography at 4h. Seven CON and nine APoC were randomised to euthanasia 15min after ROSC to isolate mitochondria from the left ventricle for bioenergetic studies.
RESULTS: ROSC was achieved in 10/15 CON and 15/17 APoC animals. APoC improved haemodynamics during CPR and post-CPR LVEF%. Mitochondrial ATP synthesis, coupling of oxidative phosphorylation and calcium retention capacity were improved in cardiac mitochondria isolated after APoC.
CONCLUSIONS: In a porcine model of prolonged untreated cardiac arrest, APoC with inhaled sevoflurane at the initiation of CPR, is associated with preserved mitochondrial function and improved post resuscitation myocardial dysfunction. Approved by the Institutional Animal Care Committee of the Minneapolis Medical Research Foundation of Hennepin County Medical Center (protocol number 11-05).
Authors:
Matthias L Riess; Timothy R Matsuura; Jason A Bartos; Martin Bienengraeber; Mohammed Aldakkak; Scott H McKnite; Jennifer N Rees; Tom P Aufderheide; Mohammad Sarraf; Robert W Neumar; Demetris Yannopoulos
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Publication Detail:
Type:  Journal Article     Date:  2014-10-02
Journal Detail:
Title:  Resuscitation     Volume:  85     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-05     Completed Date:  -     Revised Date:  2014-12-05    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  1745-51     Citation Subset:  IM    
Copyright Information:
Published by Elsevier Ireland Ltd.
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Grant Support
ID/Acronym/Agency:
R01 HL098490/HL/NHLBI NIH HHS; R01 HL108926/HL/NHLBI NIH HHS; R01 HL123227/HL/NHLBI NIH HHS; R43 HL115937/HL/NHLBI NIH HHS; R43 HL123194/HL/NHLBI NIH HHS; U01 HL077866/HL/NHLBI NIH HHS; U10 NS058927/NS/NINDS NIH HHS

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