Document Detail

Correlation between coronary perfusion pressure and quantitative ECG waveform measures during resuscitation of prolonged ventricular fibrillation.
MedLine Citation:
PMID:  22562057     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The ventricular fibrillation (VF) waveform is dynamic and predicts defibrillation success. Quantitative waveform measures (QWMs) quantify these changes. Coronary perfusion pressure (CPP), a surrogate for myocardial perfusion, also predicts defibrillation success. The relationship between QWM and CPP has been preliminarily explored. We sought to further delineate this relationship in our porcine model and to determine if it is different between animals with/without ROSC (return of spontaneous circulation).
HYPOTHESIS: A relationship exists between QWM and CPP that is different between animals with/without ROSC.
METHODS: Utilizing a prior experiment in our porcine model of prolonged out-of-hospital VF cardiac arrest, we calculated mean CPP, cumulative dose CPP, and percent recovery of three QWM during resuscitation before the first defibrillation: amplitude spectrum area (AMSA), median slope (MS), and logarithm of the absolute correlations (LAC). A random effects linear regression model with an interaction term CPP ROSC investigated the association between CPP and percent recovery QWM and how this relationship changes with/without ROSC.
RESULTS: For 12 animals, CPP and QWM measures (except LAC) improved during resuscitation. A linear relationship existed between CPP and percent recovery AMSA (coefficient 0.27; 95%CI 0.23, 0.31; p<0.001) and percent recovery MS (coefficient 0.80; 95%CI 0.70, 0.90; p<0.001). A linear relationship existed between cumulative dose CPP and percent recovery AMSA (coefficient 2.29; 95%CI 2.0, 2.56; p<0.001) and percent recovery MS (coefficient 6.68; 95%CI 6.09, 7.26; p<0.001). Animals with ROSC had a significantly "steeper" dose-response relationship.
CONCLUSIONS: There is a linear relationship between QWM and CPP during chest compressions in our porcine cardiac arrest model that is different between animals with/without ROSC.
Joshua C Reynolds; David D Salcido; James J Menegazzi
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-05-03
Journal Detail:
Title:  Resuscitation     Volume:  83     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-02     Completed Date:  2013-07-08     Revised Date:  2013-12-06    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  1497-502     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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MeSH Terms
Cardiopulmonary Resuscitation*
Coronary Circulation* / physiology
Ventricular Fibrillation / physiopathology*,  therapy*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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