| Critical time window for intra-arrest cooling with cold saline flush in a dog model of cardiopulmonary resuscitation. | |
| | |
MedLine Citation:
|
PMID: 16769925 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Mild hypothermia improves outcome when induced after cardiac arrest in humans. Recent studies in both dogs and mice suggest that induction of mild hypothermia during cardiopulmonary resuscitation (CPR) greatly enhances its efficacy. In this study, we evaluate the time window for the beneficial effect of intra-arrest cooling in the setting of prolonged CPR in a clinically relevant large-animal model. METHODS AND RESULTS: Seventeen dogs had ventricular fibrillation cardiac arrest no flow of 3 minutes, followed by 7 minutes of CPR basic life support and 50 minutes of advanced life support. In the early hypothermia group (n=9), mild hypothermia (34 degrees C) was induced with an intravenous fluid bolus flush and venovenous blood shunt cooling after 10 minutes of ventricular fibrillation. In the delayed hypothermia group (n=8), hypothermia was induced at ventricular fibrillation 20 minutes. After 60 minutes of ventricular fibrillation, restoration of spontaneous circulation was achieved with cardiopulmonary bypass for 4 hours, and intensive care was given for 96 hours. In the early hypothermia group, 7 of 9 dogs survived to 96 hours, 5 with good neurological outcome. In contrast, 7 of 8 dogs in the delayed hypothermia group died within 37 hours with multiple organ failure (P=0.012). CONCLUSIONS: Early application of mild hypothermia with cold saline during prolonged CPR enables intact survival. Delay in the induction of mild hypothermia in this setting markedly reduces its efficacy. Our data suggest that if mild hypothermia is used during CPR, it should be applied as early as possible. |
| | |
Authors:
|
Ala Nozari; Peter Safar; S William Stezoski; Xianren Wu; Scott Kostelnik; Ann Radovsky; Samuel Tisherman; Patrick M Kochanek |
Related Documents
:
|
11149445 - Rapid hypothermic aortic flush can achieve survival without brain damage after 30 minut... 7739955 - Transvenous right ventricular pacing during cardiopulmonary resuscitation of pediatric ... 19297185 - Guideline for resuscitation in cardiac arrest after cardiac surgery. 2030505 - Adequate crystalloid resuscitation restores but fails to maintain the active hepatocell... 10598735 - Native heart complications after heterotopic heart transplantation: insight into the po... 3284315 - Short-term effect of coronary artery bypass grafting on the signal-averaged electrocard... |
Publication Detail:
|
Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
|
Title: Circulation Volume: 113 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2006 Jun |
Date Detail:
|
Created Date: 2006-06-13 Completed Date: 2006-06-29 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
|
Languages: eng Pagination: 2690-6 Citation Subset: AIM; IM |
Affiliation:
|
Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114-2696. anozari@partners.org. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Brain / pathology Brain Damage, Chronic / etiology, pathology Cardiopulmonary Resuscitation / methods* Coma / etiology Dogs Electric Countershock Heart Arrest / etiology, therapy* Hemodynamics Hypothermia, Induced* / methods Myocardial Reperfusion Myocardium / pathology Necrosis Single-Blind Method Sodium Chloride / administration & dosage*, therapeutic use Time Factors* Ventricular Fibrillation / complications |
| Chemical | |
Reg. No./Substance:
|
7647-14-5/Sodium Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Causes and consequences of heart failure after prophylactic implantation of a defibrillator in the m...
Next Document: Why does the heart beat? The discovery of the electrical system of the heart.