Abstract
BackgroundLung injury is common in post-cardiac arrest syndrome, and is associated with increased morbidity and mortality. The aim of this study was to evaluate the effect of mild hypothermia on lung injury after cardiac arrest in swine based on lung ultrasound.MethodsTwenty-three male domestic swine weighing 36 ± 2 kg were randomly assigned to three groups: therapeutic hypothermia (TH, n = 9), normothermia (NT, n = 9), and sham control (control, n = 5) groups. Sham animals only underwent surgical preparation. The animal model was established with 8 min of ventricular fibrillation followed by 5 min of cardiopulmonary resuscitation. Therapeutic hypothermia was induced and maintained until 24 h post-resuscitation in the TH group by surface blanket cooling, followed by rewarming at a rate of 1 °C/h for 5 h. The extravascular lung water index (ELWI), pulmonary vascular permeability index (PVPI), PO2/FiO2, and lung ultrasound score (LUS) were measured at baseline and at 1, 3, 6, 12, 24, and 30 h after resuscitation. After euthanizing the swine, their lung tissues were quickly obtained to evaluate inflammation.ResultsAfter resuscitation, ELWI and PVPI in the NT group were higher, and PO2/FiO2 was lower, than in the sham group. However, those measures were significantly better in the TH group than the NT group. The LUS was higher in the NT group than in the sham group at 1, 3, 6, 12, 24, and 30 h after resuscitation. The LUS was significantly better in the TH group compared to the NT group. The lung tissue biopsy revealed that lung injury was more severe in the NT group than in the TH group. Increases in LUS were highly correlated with increases in ELWI (r = 0.613; p < 0.001) and PVPI (r = 0.683; p < 0.001), and decreases in PO2/FiO2 (r = − 0.468; p < 0.001).ConclusionsMild hypothermia protected against post-resuscitation lung injury in a swine model of cardiac arrest. Lung ultrasound was useful to dynamically evaluate the role of TH in lung protection.
Highlights
Lung injury is common in post-cardiac arrest syndrome, and is associated with increased morbidity and mortality
The significant morbidity and mortality of resuscitated patients are largely due to post-cardiac arrest syndrome, which is caused by whole-body ischemia and reperfusion [1]
extravascular lung water index (ELWI), pulmonary vascular permeability index (PVPI), and Partial pressure of oxygen (PO2)/Fraction of inspired oxygen (FiO2) significantly changed in the Therapeutic hypothermia (TH) and NT groups compared to the control group after resuscitation in a porcine model of VFinduced cardiac arrest
Summary
Lung injury is common in post-cardiac arrest syndrome, and is associated with increased morbidity and mortality. A series of studies have confirmed that TH provides protection from cardiac and neurological damage after resuscitation. A lung ultrasound assessment can be and quickly performed at the bedside. It captures both artifacts and effusion and consolidation, which together provide information that is important for diagnosing and monitoring acute respiratory disorders [10], guiding the positive end-expiratory pressure setting, and detecting early respiratory complications in mechanically ventilated patients. Some studies have suggested that lung ultrasound could reduce the need for standard chest radiography and CT in critically ill patients [12]
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.
