Document Detail


Improved survival and reduced myocardial necrosis with cardiopulmonary bypass reperfusion in a canine model of coronary occlusion and cardiac arrest.
MedLine Citation:
PMID:  2221517     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY QUESTION: Does cardiopulmonary bypass (CPB) improve resuscitation rates and limit infarct size after cardiac arrest and acute myocardial infarction? DESIGN: Controlled randomized trial with all animals undergoing left anterior descending coronary artery occlusion and subsequent ventricular fibrillation and resuscitation. All animals were supported for four hours after resuscitation in an intensive care setting. INTERVENTION: Group 1 (eight) was resuscitated with standard external CPR and advanced life support. Group 2 (eight) was resuscitated with CPB. MEASUREMENTS AND MAIN RESULTS: Group hemodynamic, resuscitation variables, number resuscitated, and number of four-hour survivors were compared. Ischemic and necrotic myocardial weights were determined with histochemical staining techniques in four-hour survivors. Infarct size was measured as the ratio of necrotic weight to ischemic weight. Significantly fewer dogs were resuscitated in group 1 (four of eight) than in group 2 (eight of eight) (P less than .05). Group 2 survivors required significantly less epinephrine and lidocaine than group 1 survivors (P less than .05) and higher aortic diastolic and coronary perfusion pressures after CPB (P less than .001). The ratio of myocardial necrotic weight to ischemic weight at four hours was 0.82 +/- 0.25 in group 1 and 0.22 +/- 0.25 in group 2 (P less than .05). However, collateral blood flow was not measured in this study. CONCLUSION: This pilot study further substantiates the improvement in resuscitation rates obtainable with CPB. CPB may also limit infarct size during the postresuscitation period and requires further study.
Authors:
M G Angelos; M L Gaddis; G M Gaddis; J E Leasure
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  19     ISSN:  0196-0644     ISO Abbreviation:  Ann Emerg Med     Publication Date:  1990 Oct 
Date Detail:
Created Date:  1990-11-21     Completed Date:  1990-11-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1122-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, Wright State University School of Medicine, Dayton, Ohio 45401-0927.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiopulmonary Bypass*
Coronary Disease / complications,  mortality,  therapy*
Dogs
Electric Countershock
Epinephrine / therapeutic use
Heart Arrest / etiology,  mortality,  therapy*
Hemodynamics
Lidocaine / therapeutic use
Models, Cardiovascular
Myocardial Reperfusion*
Pilot Projects
Random Allocation
Resuscitation / methods*
Chemical
Reg. No./Substance:
137-58-6/Lidocaine; 51-43-4/Epinephrine

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