Document Detail


Sodium nitroprusside enhanced cardiopulmonary resuscitation prevents post-resuscitation left ventricular dysfunction and improves 24-hour survival and neurological function in a porcine model of prolonged untreated ventricular fibrillation.
MedLine Citation:
PMID:  22208176     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM OF STUDY: Sodium nitroprusside-enhanced CPR, or SNPeCPR, consists of active compression-decompression CPR with an impedance threshold device, abdominal compression, and intravenous sodium nitroprusside (SNP). We hypothesize that SNPeCPR will improve post resuscitation left ventricular function and neurological function compared to standard (S) CPR after 15 min of untreated ventricular fibrillation in a porcine model of cardiac arrest.
METHODS: Pigs (n = 22) anesthetized with isoflurane underwent 15 min of untreated ventricular fibrillation, were then randomized to 6 min of S-CPR (n = 11) or SNPeCPR (n = 11) followed by defibrillation. The primary endpoints were neurologic function as measured by cerebral performance category (CPC) score and left ventricular ejection fraction.
RESULTS: SNPeCPR increased 24-hour survival rates compared to S-CPR (10/11 versus 5/11, p = 0.03) and improved neurological function (CPC score 2.5 ± 1, versus 3.8 ± 0.4, respectively, p = 0.004). Left ventricular ejection fractions at 1, 4 and 24 hours after defibrillation were 72 ± 11, 57 ± 11.4 and 64 ± 11 with SNPeCPR versus 29 ± 10, 30 ± 17 and 39 ± 6 with S-CPR, respectively (p < 0.01 for all).
CONCLUSIONS: In this pig model, after 15 min of untreated ventricular fibrillation, SNPeCPR significantly improved 24-hour survival rates, neurologic function and prevented post-resuscitation left ventricular dysfunction compared to S-CPR.
Authors:
Jason Schultz; Nicolas Segal; James Kolbeck; Emily Caldwell; Marit Thorsgard; Scott McKnite; Tom P Aufderheide; Keith G Lurie; Demetris Yannopoulos
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Resuscitation     Volume:  82 Suppl 2     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-01-02     Completed Date:  2012-05-22     Revised Date:  2014-09-19    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  S35-40     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier B.V. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiopulmonary Resuscitation / methods*
Disease Models, Animal
Female
Heart Arrest / complications,  physiopathology,  therapy*
Nervous System Physiological Phenomena*
Nitroprusside / administration & dosage*
Swine
Time Factors
Vasodilator Agents / administration & dosage
Ventricular Dysfunction, Left / etiology,  physiopathology,  prevention & control*
Ventricular Fibrillation / complications*,  physiopathology
Ventricular Function, Left / physiology*
Grant Support
ID/Acronym/Agency:
R01 HL108926/HL/NHLBI NIH HHS; R01 HL108926-01/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 169D1260KM/Nitroprusside
Comments/Corrections

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