| Cerebral cortical microvascular flow during and following cardiopulmonary resuscitation after short duration of cardiac arrest. | |
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MedLine Citation:
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PMID: 18280632 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To examine changes in cerebral cortical macro- and microcirculation and their relationship to the severity of brain ischaemia during and following resuscitation from a short duration of cardiac arrest. METHODS: Bilateral cranial windows were created in eight domestic pigs weighing 41+/-1 kg, exposing the frontoparietal cortex for orthogonal polarization spectral imaging together with estimation of cortical-tissue partial pressure of carbon dioxide, a quantitator of the severity of cerebral ischaemia. After 3 min of untreated ventricular fibrillation, cardiopulmonary resuscitation was begun and continued for 4 min before defibrillation. Aortic pressure, end-tidal and cortical-tissue partial pressure of carbon dioxide, and cortical microcirculatory blood flow in vessels of less and more than 20 microm in diameter were continuously measured. RESULTS: Cerebral microcirculatory blood flow progressively decreased over the 3-min interval that followed onset of ventricular fibrillation. Chest compression restored cortical microvascular flow to approximately 40% of the pre-arrest value. Following return of spontaneous circulation, microvascular flow velocity was restored to baseline values over 3 min. Reversal of cerebral ischaemia with normalisation of cerebral cortical-tissue partial pressure of carbon dioxide occurred over 7 min after resuscitation. Cortical microcirculatory blood flow in microvessels less than 20 microm was highly correlated with flow in vessels more than 20 microm together with mean aortic pressure and end-tidal partial pressure of carbon dioxide. CONCLUSION: Cerebral cortical microcirculatory flow ceased only 3 min after onset of cardiac arrest. Flow was promptly restored to 40% of its pre-arrest value after start of chest compression. After resuscitation, both macro- and microcirculatory flows were fully restored over 3 min, but cerebral ischaemia reversed more slowly. |
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Authors:
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Giuseppe Ristagno; Wanchun Tang; Shijie Sun; Max Harry Weil |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-02-15 |
Journal Detail:
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Title: Resuscitation Volume: 77 ISSN: 0300-9572 ISO Abbreviation: Resuscitation Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-04-08 Completed Date: 2008-08-26 Revised Date: 2009-08-25 |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 229-34 Citation Subset: IM |
Affiliation:
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Weil Institute of Critical Care Medicine, Rancho Mirage, CA 92270, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Animals Blood Flow Velocity / physiology Carbon Dioxide / blood Cardiopulmonary Resuscitation / methods* Cerebral Cortex / blood supply* Cerebrovascular Circulation* Heart Arrest / physiopathology*, therapy* Male Microcirculation / physiology Swine Time Factors |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide |
| Comments/Corrections | |
Comment In:
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Resuscitation. 2008 Oct;79(1):170; author reply 170-1
[PMID:
18635310
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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