Abstract
BackgroundSeveral indices exist to assess cerebral perfusion after cardiac arrest (CA). We aimed to investigate a new approach allowing absolute flow and microvascular resistance measurement based on selective arterial continuous thermodilution before and after CA resuscitation in a porcine model.MethodsIn anaesthetised pigs, intravascular absolute cerebral blood flow (CBF) and absolute coronary blood flow (ABF) with corresponding microvascular resistances were measured. CA was induced using overdrive pacing with 3 (group 1, n = 5) or 5 min (group 2, n = 8) of no flow. After resuscitation, CBF was performed at baseline, at 15 min (T15) and at 30 min (T30). Thereafter, CBF in the contralateral cerebral artery and ABF were measured.ResultsThe protocol could not be completed in three pigs from group 2 due to haemodynamic instability. In the entire cohort, CBF was significantly lower at T30 after CA (0.026 ± 0.02 L/min vs 0.040 ± 0.03 at baseline; p = 0.03) and cerebral microvascular resistances were significantly higher (3202 ± 1838 Woods units vs 2014 ± 1015 at baseline; p = 0.04). ABF and resistances remained stable at baseline, as compared to T30 (0.122 ± 0.05 vs. 0.143 ± 0.06 L/min; p = 0.15 and 563 ± 203 vs. 478 ± 181 Woods units; p = 0.36, respectively). At T30, no significant differences in cerebral flow dynamics were observed between groups.ConclusionsABF and CBF measurement after CA resuscitation is feasible with thermodilution technique, allowing accurate monitoring and measurements. This novel approach allows simultaneous measurements of flow and microvascular resistances. This animal model simplifies cerebral perfusion measurements and allows to test new therapies to reduce cerebral injury post cardiac arrest.
Highlights
Several indices exist to assess cerebral perfusion after cardiac arrest (CA)
In three pigs from group 2, we could not finalise the protocol for the following reasons: one had refractory cardiogenic shock after cardiac arrest resuscitation, one could not be resuscitated due to electrical storm
30 min after resuscitation, Cerebral blood flow (CBF) was significantly lower with a 35% flow reduction (0.040 ± 0.03 vs. 0.026 ± 0.02 L/min; P = 0.03) (Fig. 3 and Table 1)
Summary
Several indices exist to assess cerebral perfusion after cardiac arrest (CA). We aimed to investigate a new approach allowing absolute flow and microvascular resistance measurement based on selective arterial continuous thermodilution before and after CA resuscitation in a porcine model. An objective evaluation of acute cerebral perfusion appears to be essential to assess neurological prognosis, and guides clinical research and therapy. We sought to evaluate the measurement of CBF and microvascular resistances after cardiac arrest resuscitation in an animal model. We aimed to apply the same protocol in cerebral arteries to measure and monitor CBF and cerebral microvascular resistances in an animal model before and after resuscitated cardiac arrest. We hypothesised that CBF would decrease and that microvascular cerebral resistances would increase early after cardiac arrest while coronary flow will remain stable. These absolute values might be of interest in an animal setting to evaluate cerebral perfusion and better understand haemodynamic changes after cardiac arrest resuscitation
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
