Document Detail


Outcomes of CPR in the presence of partial occlusion of left anterior descending coronary artery.
MedLine Citation:
PMID:  17574322     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To develop a clinically relevant experimental model of cardiac arrest and CPR in which a partial occlusion of the left anterior descending coronary artery (LAD) is maintained during the resuscitation procedure and the initial post-resuscitation interval. MATERIALS AND METHODS: Ventricular fibrillation (VF) was induced by LAD occlusion with a balloon tipped catheter in 16 domestic male pigs weighing 41+/-2kg. After a 7min interval of untreated VF, the LAD balloon occlusion was deflated and the catheter withdrawn in eight animals. The LAD balloon was deflated in the remaining eight animals but the catheter was kept in place in order to maintain a partial occlusion of the LAD, which was approximately 75% of the internal lumen. CPR, including chest compressions and ventilations with oxygen, was then performed for 2min before a defibrillation attempt. Thirty minutes following successful resuscitation the LAD catheter was withdrawn in the animals with partial occlusion of the LAD. RESULTS: In the animals that had the LAD totally unoccluded before to starting CPR, each animal was resuscitated successfully and survived for more than 72h with better neurological recovery during the initial 24h post-resuscitation than did the partially occluded group. When a partial occlusion of the LAD was maintained during CPR, six of eight animals were resuscitated and only four of these survived for 72h. A significantly greater number of electrical shocks prior to ROSC were required when a partial occlusion of the LAD was maintained during CPR. Significantly greater severity of post-resuscitation myocardial dysfunction was observed in animals resuscitated with a partial occlusion of the LAD. CONCLUSIONS: In this model of prolonged untreated cardiac arrest, maintaining a partial occlusion of the LAD during CPR and the initial post-resuscitation interval required a greater number of shocks before ROSC, increased severity of post-resuscitation myocardial dysfunction significantly and yielded less favourable outcomes.
Authors:
Giuseppe Ristagno; Wanchun Tang; Ting Yan Xu; Shijie Sun; Max Harry Weil
Publication Detail:
Type:  Journal Article     Date:  2007-06-18
Journal Detail:
Title:  Resuscitation     Volume:  75     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-23     Completed Date:  2008-02-05     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  357-65     Citation Subset:  IM    
Affiliation:
Weil Institute of Critical Care Medicine, Rancho Mirage, CA, United States.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Cardiopulmonary Resuscitation / methods*
Coronary Stenosis / complications*
Disease Models, Animal
Heart Arrest / etiology,  mortality,  therapy*
Male
Survival Rate
Swine
Treatment Outcome
Ventricular Fibrillation / complications,  therapy

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


Previous Document:  Interferons in multiple sclerosis: ten years' experience.
Next Document:  Spontaneous gasping produces carotid blood flow during untreated cardiac arrest.