A rodent model of emergency cardiopulmonary bypass resuscitation with different temperatures after asphyxial cardiac arrest

被引:41
作者
Han, Fei [2 ]
Boller, Manuel [3 ]
Guo, Wenhui
Merchant, Raina M.
Lampe, Joshua W.
Smith, Thomas M.
Becker, Lance B. [1 ]
机构
[1] Univ Penn, Sch Med, Dept Emergency Med, Ctr Resuscitat Sci, Philadelphia, PA 19104 USA
[2] Harbin Med Coll, Affiliated Hosp 3, Dept Anesthesiol, Harbin, Heilongjiang, Peoples R China
[3] Univ Penn, Sch Vet Med, Dept Clin Studies, Philadelphia, PA 19104 USA
关键词
Cardiopulmonary bypass; Heart arrest; Hypothermia; Cardiopulmonary resuscitation; Reperfusion; EXTRACORPOREAL MEMBRANE-OXYGENATION; MILD HYPOTHERMIA; PEDIATRIC-PATIENTS; FEASIBILITY TRIAL; RATS; SURVIVAL; BRAIN; SUPPORT; DEATH; DOGS;
D O I
10.1016/j.resuscitation.2009.09.018
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: The use of emergency cardiopulmonary bypass (ECPB) resuscitation after cardiac arrest may offer hope for survival when standard ACLS therapies fail. However, whether cooling adds benefit to ECPB is unknown and we lack an ECPB rodent model for experimental studies. We sought to (a) develop a 72 h survival rodent model using ECPB to treat asphyxial cardiac arrest and (b) use this new model to evaluate early mild and moderate hypothermia versus normothermia during ECPB resuscitation. Methods: After 8 min of normothermic asphyxia, three groups of rats were resuscitated with ECPB at 37 degrees C (NORM), 34 degrees C (MILD) and 30 degrees C (MOD) for I h (n = 10 each). During the second resuscitation hour, ECPB was discontinued, ventilatory support was provided and body temperatures were maintained at 37 degrees C for NORM, 34 degrees C for MILD, and from 30 degrees C gradually up to 34 degrees C in 1 h for MOD animals. From hours 3 to 8, body temperature was maintained at 37 degrees C for NORM and 34 degrees C for MILD and MOD animals. Results: All rats were initially resuscitated by ECPB. After 72 h, neurological Outcome and survival in the MILD (60% survival) and MOD (80%) groups were significantly better than in the NORM (0%) group (p < 0.05). Overall performance recovery in the MOD group was best (vs. the NORM group), while the MILD group had an intermediate outcome. Conclusions: A rodent model of ECPB is feasible and useful for resuscitation Studies. The addition of early mild and moderate hypothermia to ECPB resuscitation significantly improves survival compared with normothermic ECPB in rats. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:93 / 99
页数:7
相关论文
共 38 条
  • [1] Intra-arrest cooling improves outcomes in a murine cardiac arrest model
    Abella, BS
    Zhao, DH
    Alvarado, J
    Hamann, K
    Vanden Hoek, TL
    Becker, LB
    [J]. CIRCULATION, 2004, 109 (22) : 2786 - 2791
  • [2] Sudden cardiac death
    Ali, Sheharyar
    Antezano, Eduardo S.
    [J]. SOUTHERN MEDICAL JOURNAL, 2006, 99 (05) : 502 - 510
  • [3] Survival outcomes after rescue extracorporeal cardiopulmonary resuscitation in pediatric patients with refractory cardiac arrest
    Alsoufi, Bahaaldin
    Al-Radi, Osman O.
    Nazer, Rakan I.
    Gruenwald, Colleen
    Foreman, Celeste
    Williams, William G.
    Coles, John G.
    Caldarone, Christopher A.
    Bohn, Desmond G.
    Van Arsdell, Glen S.
    [J]. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2007, 134 (04) : 952 - U43
  • [4] [Anonymous], N ENGL J MED
  • [5] [Anonymous], 2002, MMWR MORB MORTAL WKL, V51, P123
  • [6] Long-term mild hypothermia with extracorporeal lung and heart assist improves survival from prolonged cardiac arrest in dogs
    Ao, H
    Tanimoto, H
    Yoshitake, A
    Moon, JK
    Terasaki, H
    [J]. RESUSCITATION, 2001, 48 (02) : 163 - 174
  • [7] Sudden cardiac death: Directing the scope of resuscitation towards the heart and brain
    Athanasuleas, Constantine L.
    Buckberg, Gerald D.
    Allen, Bradley S.
    Beyersdorf, Friedhelm
    Kirsh, Marvin M.
    [J]. RESUSCITATION, 2006, 70 (01) : 44 - 51
  • [8] Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia
    Bernard, SA
    Gray, TW
    Buist, MD
    Jones, BM
    Silvester, W
    Gutteridge, G
    Smith, K
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2002, 346 (08) : 557 - 563
  • [9] Carrillo P, 1998, J TRAUMA, V45, P239, DOI 10.1097/00005373-199808000-00007
  • [10] Blood cardioplegic protection in profoundly damaged hearts:: Role of Na+-H+ exchange inhibition during pretreatment or during controlled reperfusion supplementation
    Castellá, M
    Buckberg, GD
    Tan, ZT
    [J]. ANNALS OF THORACIC SURGERY, 2003, 75 (04) : 1238 - 1245