Vasopressor Response in a Porcine Model of Hypothermic Cardiac Arrest Is Improved with Active Compression-Decompression Cardiopulmonary Resuscitation Using the Inspiratory Impedance Threshold Valve

• DOI: 10.1097/00000539-200212000-00007
• Publication Date: 2004-07-29T23:13:13Z
• Authors: Claus Raedler; Wolfgang G. Voelckel; Volker Wenzel; Ludger Bahlmann; Wolfgang Baumeier; Christian A. Schm...; Holger Herff; Anette C. Krismer; Karl H. Lindner; Keith G. Lurie
• Keywords: Coronary perfusion pressure

During normothermic cardiac arrest, a combination of active compression-decompression (ACD) cardiopulmonary resuscitation (CPR) with the inspiratory threshold valve (ITV) significantly improves vital organ blood flow, but this technique has not been studied during hypothermic arrest. Accordingly, we evaluated hemodynamic effects ACD + ITV CPR before, and after, administration vasopressin in porcine model Pigs were surface-cooled until their body core temperature was 26°C. After 10 min untreated ventricular fibrillation, 14 animals randomly assigned to either (n = 7) or standard (STD) 7). 8 CPR, all received 0.4 U/kg IV, maintained for an additional each group; defibrillation attempted after 28 including 18 CPR. Before vasopressin, mean ± sem common carotid flow higher group com-pared STD (67 13 versus 26 5 mL/min, respectively;P < 0.025). given at minute coronary perfusion pressure group, did increase (29 3 15 2 mm Hg, 25 1 Hg 12 18, 0.001); remained respective time points (33 31 7 0.01). Without rewarming, spontaneous circulation restored h three seven none (not significant). improved compared alone. Moreover,