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Early selective trans-nasal cooling during CPR improves success of resuscitation in a porcine model of prolonged pulseless electrical activity cardiac arrest.
MedLine Citation:
PMID:  21592641     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM OF STUDY: In the present study, we investigated trans-nasal cooling in settings of pulseless electrical activity (PEA). We hypothesized that early trans-nasal cooling during CPR improves outcomes when cardiac arrest is associated with PEA. METHODS: Ventricular fibrillation (VF) was electrically induced in 16 domestic male pigs weighing 40±3kg. After 14min of untreated VF, PEA was induced following delivery of one or more electrical shocks. One min after onset of PEA, CPR was started, including chest compression and ventilation. Each animal received 5min of CPR prior to defibrillation attempt. CPR and resuscitation efforts were discontinued at 15min unless return to spontaneous circulation was achieved. In 8 animals, selective trans-nasal cooling was begun coincident with start of CPR and 8 randomized controls were identically treated except for trans-nasal cooling. Mean aortic pressure was continuously measured together with aortic and right atrial pressure and nasal, body and right jugular vein temperatures. Coronary perfusion pressure (CPP) was computed from measured data. RESULTS: Six of eight animals were resuscitated after early trans-nasal cooling, while only one untreated control was resuscitated (p=0.012). Nasal, body and jugular vein temperatures decreased after cooling. At PC (precordial compression) 5min, the cooled group recorded a higher CPP (25±5mmHg) than the non-cooled group (15±4mmHg, p=0.001). CONCLUSION: When selective trans-nasal cooling was initiated during CPR in the animal model of prolonged cardiac arrest with PEA, CPP was higher and the likelihood of return of spontaneous circulation was improved.
Authors:
Jun Hwi Cho; Giuseppe Ristagno; Yongqin Li; Shijie Sun; Max Harry Weil; Wanchun Tang
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-21
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-5-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
The Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA; Department of Emergency Medicine, School of Medicine, Kangwon National University, Gangwondo, South Korea.
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