Adrenaline improves regional cerebral blood flow, cerebral oxygenation and cerebral metabolism during CPR in a porcine cardiac arrest model using low-flow extracorporeal support.
Adrenaline
Blood pressure
Cardiac arrest
Cardiopulmonary resuscitation
Cerebral cortex/metabolism
Ecmo
Heart arrest/therapy
Microdialysis/methods
Near infrared spectroscopy
Oxygen/blood
Oxygen/metabolism
Pigs
Journal
Resuscitation
ISSN: 1873-1570
Titre abrégé: Resuscitation
Pays: Ireland
ID NLM: 0332173
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
07
03
2021
revised:
05
07
2021
accepted:
28
07
2021
pubmed:
8
8
2021
medline:
3
11
2021
entrez:
7
8
2021
Statut:
ppublish
Résumé
The effects of adrenaline on cerebral blood vessels during cardiopulmonary resuscitation (CPR) are not well understood. We developed an extracorporeal CPR model that maintains constant low systemic blood flow while allowing adrenaline-associated effects on cerebral vasculature to be assessed at different mean arterial pressure (MAP) levels independently of the effects on systemic blood flow. After eight minutes of cardiac arrest, low-flow extracorporeal life support (ECLS) (30 ml/kg/min) was started in fourteen pigs. After ten minutes, continuous adrenaline administration was started to achieve MAP values of 40 (n = 7) or 60 mmHg (n = 7). Measurements included intracranial pressure (ICP), cerebral perfusion pressure (CePP), laser-Doppler-derived regional cerebral blood flow (CBF), cerebral regional oxygen saturation (rSO During ECLS without adrenaline, regional CBF increased by only 5% (25th to 75th percentile: -3 to 14; p = 0.2642) and P This study shows that adrenaline administration during constant low systemic blood flow increases CePP, regional CBF, cerebral oxygenation and cerebral metabolism.
Sections du résumé
BACKGROUND
The effects of adrenaline on cerebral blood vessels during cardiopulmonary resuscitation (CPR) are not well understood. We developed an extracorporeal CPR model that maintains constant low systemic blood flow while allowing adrenaline-associated effects on cerebral vasculature to be assessed at different mean arterial pressure (MAP) levels independently of the effects on systemic blood flow.
METHODS
After eight minutes of cardiac arrest, low-flow extracorporeal life support (ECLS) (30 ml/kg/min) was started in fourteen pigs. After ten minutes, continuous adrenaline administration was started to achieve MAP values of 40 (n = 7) or 60 mmHg (n = 7). Measurements included intracranial pressure (ICP), cerebral perfusion pressure (CePP), laser-Doppler-derived regional cerebral blood flow (CBF), cerebral regional oxygen saturation (rSO
RESULTS
During ECLS without adrenaline, regional CBF increased by only 5% (25th to 75th percentile: -3 to 14; p = 0.2642) and P
CONCLUSION
This study shows that adrenaline administration during constant low systemic blood flow increases CePP, regional CBF, cerebral oxygenation and cerebral metabolism.
Identifiants
pubmed: 34363854
pii: S0300-9572(21)00289-6
doi: 10.1016/j.resuscitation.2021.07.036
pii:
doi:
Substances chimiques
Epinephrine
YKH834O4BH
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
151-159Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.