| Percutaneous left ventricular assist in ischemic cardiac arrest. | |
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MedLine Citation:
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PMID: 19242324 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Ischemic cardiac arrest represents a challenge for optimal emergency revascularization therapy. A percutaneous left ventricular assist device (LVAD) may be beneficial. OBJECTIVE: To determine the effect of a percutaneous LVAD during cardiac arrest without chest compressions and to assess the effect of fluid loading. DESIGN: Totally, 16 pigs randomized to either conventional or intensive fluid with LVAD support during ventricular fibrillation (VF). SETTING: Acute experimental trial with pigs under general anesthesia. SUBJECTS: Farm pigs of both sexes. INTERVENTIONS: After randomization for fluid infusion, VF was induced by balloon occlusion of the proximal left anterior descending artery. LVAD and fluid were started after VF had been induced. MEASUREMENTS: Brain, kidney, myocardial tissue perfusion, and cardiac index were measured with the microsphere injection technique at baseline, 3, and 15 minutes. Additional hemodynamic monitoring continued until 30 minutes. MAIN RESULTS: At 15 minutes, vital organ perfusion was maintained without significant differences between the two groups. Mean cardiac index at 3 minutes of VF was 1.2 L x min(-1) x m2 (29% of baseline, p < 0.05). Mean perfusion at 3 minutes was 65% in the brain and 74% in the myocardium compared with baseline (p < 0.05), then remained unchanged during the initial 15 minutes. At 30 minutes, LVAD function was sustained in 11 of 16 animals (8 of 8 intensified fluid vs. 3 of 8 conventional fluid) and was associated with intensified fluid loading (p < 0.001). CONCLUSIONS: During VF, a percutaneous LVAD may sustain vital organ perfusion. A potential clinical role of the device during cardiac arrest has yet to be established. |
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Authors:
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Vegard Tuseth; Mohamed Salem; Reidar Pettersen; Ketil Grong; Svein Rotevatn; Tore Wentzel-Larsen; Jan Erik Nordrehaug |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 37 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-25 Completed Date: 2009-05-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1365-72 Citation Subset: AIM; IM |
Affiliation:
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Department of Heart Disease, Haukeland University Hospital, N-5021 Bergen, Norway. vegard.tuseth@helse-bergen.no |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Heart Arrest / etiology*, physiopathology, surgery* Heart-Assist Devices* Myocardial Ischemia / complications*, physiopathology Swine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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