Document Detail


Microvascular blood flow during cardiopulmonary resuscitation is predictive of outcome.
MedLine Citation:
PMID:  16987589     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There is growing evidence that microcirculatory blood flow is the ultimate determinant of the outcome in circulatory shock states. We therefore examined changes in the microcirculation accompanying the most severe form of circulatory failure, namely cardiac arrest and the effects of subsequent cardiopulmonary resuscitation. Ventricular fibrillation was electrically induced in nine pigs and untreated for 5min prior to beginning closed chest cardiac compression and attempting electrical defibrillation. Orthogonal polarization spectral imaging was utilized for visualization of the sublingual microcirculation at baseline, 0.5, 1, 3 and 5min after onset of ventricular fibrillation and at 1 and 5min after start of chest compression. Images were also obtained 1 and 5min after restoration of spontaneous circulation. Microvascular flow was graded from 0 (no flow) to 3 (normal flow). Aortic and right atrial pressures were measured and coronary perfusion pressure was computed continuously. Microcirculatory blood flow decreased to less than one-fourth within 0.5min after inducing ventricular fibrillation. Precordial compression partially restored microvascular flow in each animal. In animals that were successfully resuscitated, microvascular flow was significantly greater after 1 and 5min of chest compression than in animals with failed resuscitation attempts. Microvascular blood flow was highly correlated with coronary perfusion pressure (r=0.82, p<0.01). Microvascular blood flow in the sublingual mucosa is therefore closely related to coronary perfusion pressure during cardiopulmonary resuscitation and both are predictive of outcome.
Authors:
Michael Fries; Wanchun Tang; Yun-Te Chang; Jinglan Wang; Carlos Castillo; Max Harry Weil
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Publication Detail:
Type:  Journal Article     Date:  2006-09-20
Journal Detail:
Title:  Resuscitation     Volume:  71     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-27     Completed Date:  2007-02-05     Revised Date:  2012-05-30    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  248-53     Citation Subset:  IM    
Affiliation:
The Weil Institute of Critical Care Medicine, 35100 Bob Hope Drive, Rancho Mirage, CA 92270, United States.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Pressure
Carbon Dioxide / blood
Cardiopulmonary Resuscitation*
Coronary Circulation*
Electric Countershock*
Heart Arrest, Induced*
Male
Microcirculation
Models, Animal
Mouth Floor / blood supply
Swine
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

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


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