Abstract 15923: Dose-dependent Effect of Sevoflurane Postconditioning on Coronary Perfusion Pressure During Early Cardiopulmonary Resuscitation in a Pig Model of Prolonged Cardiac Arrest

Abstract

Introduction: Pharmacologic postconditioning with the inhaled anesthetic sevoflurane (SEVO) during cardiopulmonary resuscitation (CPR) has been shown to improve outcomes in a porcine model of prolonged cardiac arrest. Hypothesis: We hypothesized that SEVO works in part by improving coronary perfusion pressure (CPP) during CPR. Methods: Following 15 min of untreated ventricular fibrillation (VF), 16 pigs received mechanical CPR for 4 min without (CON) or with low- (2 Vol%) or high-dose (4 Vol%) inhaled SEVO for 3 min. CPP was measured as the difference between mean aortic pressure and right atrial pressure during chest decompression. Results: CPP (mean±SEM in mmHg) at min 3 and 4 of CPR was higher in high-dose SEVO (46±4) than in low-dose SEVO (23±3) or CON (34±4); there was no significant difference between the latter two. Conclusions: Our data show that pharmacologic postconditioning with SEVO resulted in improved CPP during mechanical CPR if a sufficiently high dose is given. Combined with negligible metabolism and fast uptake and washout by ventilation due to its low solubility coefficient, SEVO may be a suitable drug to improve outcomes after cardiac arrest when given short-term during early CPR. If SEVO is associated with enhanced blood flow generation due to its known vasodilatory effect needs to be determined in future studies.