Document Detail


Sodium nitroprusside enhanced cardiopulmonary resuscitation improves survival with good neurological function in a porcine model of prolonged cardiac arrest.
MedLine Citation:
PMID:  21358401     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the effectiveness of sodium nitroprusside (SNP)-"enhanced" cardiopulmonary resuscitation (SNPeCPR) on 24-hr survival rates compared to standard CPR in animals after cardiac arrest. SNPeCPR consists of large intravenous SNP bolus doses during CPR enhanced by active compression-decompression CPR, an inspiratory impedance threshold device (ITD), and abdominal binding (AB). The combination of active compression-decompression CPR+ITD+AB without SNP will be called "enhanced" or eCPR.
DESIGN: Randomized, blinded, animal study.
SETTING: Preclinical animal laboratory.
SUBJECTS: Twenty-four female farm pigs (30 ± 1 kg).
INTERVENTIONS: Isoflurane anesthetized and intubated pigs were randomized after 8 mins of untreated ventricular fibrillation to receive either standard CPR (n = 8), SNPeCPR (n = 8), or eCPR (n = 8) for 25 mins followed by defibrillation.
MEASUREMENTS AND MAIN RESULTS: The primary end point was carotid blood flow during CPR and 24-hr survival with good neurologic function defined as an overall performance category score of ≤2 (1 = normal, 5 = brain dead or dead). Secondary end points included hemodynamics and end-tidal CO2. SNPeCPR significantly improved carotid blood flow and 24-hr survival rates with good neurologic function compared to standard CPR or eCPR (six of eight vs. zero of eight vs. one of eight, p < .05). The improved survival rates were associated with higher coronary perfusion pressure and ETco2 during CPR.
CONCLUSION: In pigs, SNPeCPR significantly improved hemodynamics, resuscitation rates, and 24-hr survival rates with good neurologic function after cardiac arrest when compared with standard CPR or eCPR alone.
Authors:
Demetris Yannopoulos; Timothy Matsuura; Jason Schultz; Kyle Rudser; Henry R Halperin; Keith G Lurie
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  39     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-25     Completed Date:  2011-08-11     Revised Date:  2013-03-25    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1269-74     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Minnesota, Minneapolis-St. Paul, MN, USA. yanno001@umn.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiopulmonary Resuscitation / methods*
Carotid Arteries / physiology
Disease Models, Animal
Female
Heart Arrest / etiology,  therapy*
Nitroprusside / therapeutic use*
Regional Blood Flow
Swine
Vasodilator Agents / therapeutic use*
Grant Support
ID/Acronym/Agency:
R01 HL108926/HL/NHLBI NIH HHS; R01 HL108926-02/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 15078-28-1/Nitroprusside
Comments/Corrections
Comment In:
Crit Care Med. 2011 Jun;39(6):1548-9   [PMID:  21610615 ]
Crit Care Med. 2012 Jan;40(1):360; author reply 360-1   [PMID:  22179388 ]

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


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