Abstract 2059: Transthoracic Application of Medium Voltage Therapy Maintains Forward Blood Flow during Cardiac Arrest

Abstract

We have previously reported that transthoracic medium voltage therapy (MVT) generated coronary perfusion pressure (CPP), forward carotid blood flow (CBF) and end-tidal CO 2 (EtCO 2 ) comparable to those produced by manual chest compression. In the present study, we investigated the capability of MVT to generate and maintain forward blood flow for a longer interval, i.e. 1 min, in a porcine model of short duration cardiac arrest. MVT can maintain threshold levels of CPP, CBF and EtCO 2 , for a minute interval prior to defibrillation. In 7 domestic male pigs weighing 40 ± 1 kg, VF was electrically induced and untreated for 10 seconds. Animals were then subjected to receive MVT for one minute with the aid of a Galvani E-CPR device (Galvani Ltd, Edina, MN), after when a biphasic shock was delivered. The MVT pulsed packet was 400 msec, the pulsed packet rate was 80/min, the intra-packet pulse period was 25 ms and intra-packet pulse durations were 0.2 ms. CPP and EtCO2 were continuously measured during MVT. CBF and ejection fraction generated during MVT were measured by echo-Doppler technique, while cardiac output with stroke volume by thermodiluition method. MVT was able to maintain CPP and EtCO2 above the threshold levels for successful resuscitation for the entire interval of application (Table ). During MVT, excellent stroke volume, cardiac output and ejection fraction together with carotid blood flow were generated (Table ). MVT produced and maintained for one minute forward blood flow during cardiac arrest. This electrical therapy might represent a new approach intended to generate and/or maintain forward blood flow in lieu of or in association with chest compression in victims of cardiac arrest