Abstract 28: Administration of Intravenous Ascorbic Acid Following Return of Spontaneous Circulation, with and Without Hypothermia, Improved Both Myocardial Dysfunction and Survival from Ventricular Fibrillation Cardiac Arrest

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Background Our previous studies disclosed intravenous administration of ascorbic acid (AA) during CPR facilitates resuscitation and improves outcomes in VF cardiac arrest. However, the effect of AA administrated after ROSC and the interaction with hypothermia has not been clarified. Hypothesis Intravenous administration of AA after ROSC, with and without hypothermia, both can improve myocardial dysfunction and survival in VF cardiac arrest. Methods The animals were equally randomized to AA, hypothermia, AA+hypothermia and control groups. VF was induced and untreated for 5 minutes, followed by 1 minutes of CPR, and then one electrical shock of 5 J. After ROSC, the AA and AA+hypothermia group received intravenous administration of AA (100 mg/kg), and the hypothermia and control group received saline as placebo. In the hypothermia and AA+hypothermia groups, therapeutic hypothermia of 32°C was applied for 2 hours following ROSC. Malondialdehyde(MDA) of myocardium was assessed to determine oxidative stress. Results Within the first 2 hours, the control and the AA groups had higher heart rates than the hypothermia and AA+hypothermia groups. At the 4 th hour, the AA, hypothermia and AA+hypothermia groups had significant lower MDA concentration than the control group ( p <0.05). The AA, hypothermia and AA+hypothermia groups had better dp/dt 40 and -dp/dt max than the control group, within 4 hours following ROSC (Table 1). Histological exam showed less myocytolysis in the AA, hypothermia and AA+hypothermia groups than in the control group. The AA, hypothermia and AA+hypothermia groups had better survival than the control group ( p <0.05), but there was no difference between the AA, hypothermia and AA+hypothermia groups. Conclusion Intravenous administration of AA after ROSC, with and without hypothermia, both may improve myocardial dysfunction and survival in VF cardiac arrest.