Abstract 2000: Rapid Brain Cooling During Cardiopulmonary Resuscitation Followed By Systemic Therapeutic Hypothermia Reduces The Severity Of Post-resuscitation Myocardial Dysfunction In A Porcine Model Of Prolonged Ventricular Fibrillation
Background: Therapeutic hypothermia has been known to reduce post-resuscitation neurological deficit and protect the cardiomyocyte from ischemia/reperfusion injury.
Hypothesis: Rapid brain cooling during CPR followed by systemic cooling reduces the severity of post-resuscitation myocardial dysfunction after prolonged ventricular fibrillation (VF)
Methods: VF was induced in 16 domestic pigs and untreated for 10 minutes. CPR was then initiated for 5 minutes before defibrillation attempts. Coincident with starting CPR, the hypothermia group (n=8) was cooled by a Rhinochill device, which cooled the brain, followed by systemic hypothermia. The cooling was continued to achieve a target core temperature of 34°C.The body temperature of the control group was not intervened after VF was induced. Transthoracic echocardiography was performed before VF, hourly after return of spontaneous circulation (ROSC) for 4 hours, and at 96 hours.
Results: Both myocardial systolic (LVEF) and diastolic (isovolumic relaxation time, IVRT) functions were significantly better in the cooled animals during the entitled observation period when compared with control animals (Table 1⇓). All cooled animals survived for 96 hours after ROSC. However, only 2 of 8 control animals survived more than 96 hours after ROSC.
Conclusion: Early induction of both brain and systemic hypothermia significantly reduces the severity of post-resuscitation myocardial dysfunction and improves post-resuscitation survival.