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Haemodynamic impact of aortic balloon occlusion combined with percutaneous left ventricular assist device during cardiopulmonary resuscitation in a swine model of cardiac arrest.
Tiba, Mohamad Hakam; Nakashima, Takahiro; McCracken, Brendan M; Hsu, Cindy H; Gottula, Adam L; Greer, Nicholas L; Cramer, Traci A; Sutton, Nadia R; Ward, Kevin R; Neumar, Robert W.
Afiliação
  • Tiba MH; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States; The Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, MI, United States. Electronic address: tibam@umich.edu.
  • Nakashima T; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States; The Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, MI, United States. Electronic address: takana@umich.edu.
  • McCracken BM; Department of Radiology, University of Michigan, Ann Arbor, MI, United States. Electronic address: bmccrac@umich.edu.
  • Hsu CH; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States; The Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, MI, United States. Electronic address: hcindy@umich.edu.
  • Gottula AL; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States; The Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, MI, United States. Electronic address: adgottul@umich.edu.
  • Greer NL; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States; The Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, MI, United States. Electronic address: nlgreer@umich.edu.
  • Cramer TA; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States; The Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, MI, United States. Electronic address: crtraci@umich.edu.
  • Sutton NR; Department of Internal Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, United States. Electronic address: nadia.sutton@vumc.org.
  • Ward KR; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States; The Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, MI, United States; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United St
  • Neumar RW; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States; The Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, MI, United States. Electronic address: neumar@umich.edu.
Resuscitation ; 189: 109885, 2023 08.
Article em En | MEDLINE | ID: mdl-37385400
ABSTRACT

AIM:

To investigate the effect of tandem use of transient balloon occlusion of the descending aorta (AO) and percutaneous left ventricular assist device (pl-VAD) during cardiopulmonary resuscitation in a large animal model of prolonged cardiac arrest.

METHODS:

Ventricular fibrillation was induced and left untreated for 8 minutes followed by 16 minutes of mechanical CPR (mCPR) in 24 swine, under general anesthesia. Animals were randomized to 3 treatment groups (n = 8 per group) A) pL-VAD (Impella CP®) B) pL-VAD+AO, and C) AO. Impella CP® and the aortic balloon catheter were inserted via the femoral arteries. mCPR was continued during treatment. Defibrillation was attempted 3 times starting at minute 28 and then every 4 minutes. Haemodynamic, cardiac function and blood gas measurements were recorded for up to 4 hours.

RESULTS:

Coronary perfusion pressure (CoPP) in the pL-VAD+AO Group increased by a mean (SD) of 29.2(13.94) mmHg compared to an increase of 7.1(12.08) and 7.1(5.95) mmHg for groups pL-VAD and AO respectively (p = 0.02). Similarly, cerebral perfusion pressure (CePP) in pL-VAD+AO increased by a mean (SD) of 23.6 (6.11), mmHg compared with 0.97 (9.07) and 6.9 (7.98) mmHg for the other two groups (p < 0.001). The rate of return of spontaneous heartbeat (ROSHB) was 87.5%, 75%, and 100% for pL-VAD+AO, pL-VAD, and AO.

CONCLUSION:

Combined AO and pL-VAD improved CPR hemodynamics compared to either intervention alone in this swine model of prolonged cardiac arrest.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Coração Auxiliar / Reanimação Cardiopulmonar / Oclusão com Balão / Parada Cardíaca Tipo de estudo: Clinical_trials Limite: Animals Idioma: En Ano de publicação: 2023 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Coração Auxiliar / Reanimação Cardiopulmonar / Oclusão com Balão / Parada Cardíaca Tipo de estudo: Clinical_trials Limite: Animals Idioma: En Ano de publicação: 2023 Tipo de documento: Article