Improved survival and reduced myocardial necrosis with cardiopulmonary bypass reperfusion in a canine model of coronary occlusion and cardiac arrest

Mark G. Angelos, Monica I. Gaddis, Gary Gaddis, James E. Leasure

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Study question: Does cardiopulmonary bypass (CPB) improve resuscitation rates and limit infarct size after cardiac arrest and acute myocardial infarction? Design: Controlled randomized trial with all animals undergoing left anterior descending coronary artery occlusion and subsequent ventricular fibrillation and resuscitation. All animals were supported for four hours after resuscitation in an intensive care setting. Intervention: Group 1 (eight) was resuscitated with standard external CPR and advanced life support. Group 2 (eight) was resuscitated with CPB. Measurements and main results: Group hemodynamic, resuscitation variables, number resuscitated, and number of four-hour survivors were compared. Ischemic and necrotic myocardial weights were determined with histochemical staining techniques in four-hour survivors. Infarct size was measured as the ratio of necrotic weight to ischemic weight. Significantly fewer dogs were resuscitated in group 1 (four of eight) than in group 2 (eight of eight) (P < .05). Group 2 survivors required significantly less epinephrine and lidocaine than group 1 survivors (P < .05) and higher aortic diastolic and coronary perfusion pressures after CPB (P < .001). The ratio of myocardial necrotic weight to ischemic weight at four hours was 0.82 ± 0.25 in group 1 and 0.22 ± 0.25 in group 2 (P < .05). However, collateral blood flow was not measured in this study. Conclusion: This pilot study further substantiates the improvement in resuscitation rates obtainable with CPB. CPB may also limit infarct size during the postresuscitation period and requires further study.

Original languageEnglish
Pages (from-to)1122-1128
Number of pages7
JournalAnnals of emergency medicine
Volume19
Issue number10
DOIs
StatePublished - Oct 1990

Keywords

  • cardiopulmonary bypass

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