Journal article
Liquid ventilation with perfluorocarbons facilitates resumption of spontaneous circulation in a swine cardiac arrest model
Resuscitation, Vol.78(1), pp.77-84
2008
DOI: 10.1016/j.resuscitation.2008.02.008
PMCID: PMC2483299
PMID: 18406036
Abstract
Induced external hypothermia during ventricular fibrillation (VF) improves resuscitation outcomes. Our objectives were twofold (1) to determine if very rapid hypothermia could be achieved by intrapulmonary administration of cold perfluorocarbons (PFC), thereby using the lungs as a vehicle for targeted cardiopulmonary hypothermia, and (2) to determine if this improved resuscitation success.
Part 1: Nine female swine underwent static intrapulmonary instillation of cold perfluorocarbons (PFC) during electrically induced VF. Part 2: Thirty-three female swine in VF were immediately ventilated via total liquid ventilation (TLV) with pre-oxygenated cold PFC (−15
°C) or warm PFC (33
°C), while control swine received no ventilation during VF. All swine in both Parts 1 and 2 underwent VF arrest for 11
min, then defibrillation, ventilation and closed chest massage until resumption of spontaneous circulation (ROSC). The endpoint was continued spontaneous circulation for 1
h without pharmacologic support.
Static intrapulmonary instillation of cold PFC achieved rapid cardiopulmonary hypothermia; pulmonary artery (PA) temperature of 33.5
±
0.2
°C was achieved by 10
min. Nine of 9 achieved ROSC. Hypothermia was achieved faster using TLV: at 6
min VF, cold TLV temperature was 32.9
±
0.4
°C vs. cold static instillation temperature 34.3
±
0.2
°C. Nine of 11 cold TLV swine achieved ROSC for 1
h vs. 3 of 11 control swine (
p
=
0.03). Warm PFC also appeared to be beneficial, with a trend toward greater achievement of ROSC than control (ROSC; warm PFC 8 of 11 vs. control 3 of 11,
p
=
0.09).
Targeted cardiopulmonary intra-arrest moderate hypothermia was achieved rapidly by static intrapulmonary administration of cold PFC and more rapidly by total liquid ventilation with cold PFC; resumption of spontaneous circulation was facilitated. Warm PFC showed a trend toward facilitating ROSC.
Details
- Title: Subtitle
- Liquid ventilation with perfluorocarbons facilitates resumption of spontaneous circulation in a swine cardiac arrest model
- Creators
- Kimberly S Staffey - Department of Internal Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, United StatesRaghuveer Dendi - Electrophysiology Institute, Beth Israel Deaconess Hospital, 330 Brookline Avenue, Boston, MA 02215-5400, United StatesLeonard A Brooks - Department of Internal Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, United StatesAndrew M Pretorius - Department of Internal Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, United StatesLaynez W Ackermann - Department of Emergency Medicine, University of Iowa Hospitals, 200 Hawkins Drive, Iowa City, IA 52242, United StatesK.D Zamba - Department of Biostatistics, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, United StatesEric Dickson - Department of Emergency Medicine, University of Iowa Hospitals, 200 Hawkins Drive, Iowa City, IA 52242, United StatesRichard E Kerber - Department of Internal Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, United States
- Resource Type
- Journal article
- Publication Details
- Resuscitation, Vol.78(1), pp.77-84
- DOI
- 10.1016/j.resuscitation.2008.02.008
- PMID
- 18406036
- PMCID
- PMC2483299
- NLM abbreviation
- Resuscitation
- ISSN
- 0300-9572
- eISSN
- 1873-1570
- Publisher
- Elsevier Ireland Ltd
- Language
- English
- Date published
- 2008
- Academic Unit
- Radiology; Biostatistics; Surgery; Internal Medicine
- Record Identifier
- 9983997475502771
Metrics
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