Role of Epinephrine and Extracorporeal Membrane Oxygenation in the Management of Ischemic Refractory Ventricular Fibrillation

• DOI: 10.1016/j.jacbts.2017.02.003
• Publication Date: 2017-06-22T09:22:53Z
• Authors: Jason A. Bartos; Sebastian Voicu; Timothy R. Matsuura; Adamantios Tsangaris; Georgios Sideris; Brett A. Oestreich; Stephen A. George; Matthew Olson; Kadambari Chandra...; Jennifer N. Rees; Kathleen Carlson; Pierre Sebastian; Scott McKnite; Ganesh Raveendran; Tom P. Aufderheide; Demetris Yannopoulos
• Keywords: PRECLINICAL RESEARCH; 03 medical and health sciences; 0302 clinical medicine; RC666-701; Diseases of the circulatory (Cardiovascular) system; 3. Good health

xtracorporeal membrane oxygenation (ECMO) is used in cardiopulmonary resuscitation (CPR) of refractory cardiac arrest. We used a 2×2 study design to compare ECMO versus CPR and epinephrine versus placebo in a porcine model of ischemic refractory ventricular fibrillation (VF). Pigs underwent 5 minutes of untreated VF, 10 minutes of CPR, and were randomized to receive epinephrine versus placebo for another 35 minutes. Animals were further randomized to LAD reperfusion at minute 45 with ongoing CPR versus veno-arterial ECMO cannulation at minute 45 of CPR and subsequent LAD reperfusion. Four-hour survival was improved with ECMO while epinephrine showed no effect.