Abstract 2836: Pre-shock CPR Worsens Outcome from Circulatory Phase VF with Acute Coronary Artery Obstruction in Swine
Background: Studies in animals with normal coronary arteries indicate that pre-shock CPR can be beneficial during the circulatory phase of VF. Some clinical studies have shown benefits from pre-shock CPR, but others have not.
Hypothesis Pre-shock CPR will improve outcome after 8 minutes of VF (i.e., during the circulatory phase) in a swine model with acute coronary obstruction.
Methods: 26 swine (27±1 kg) were anesthetized with isoflurane and instrumented with micromanometer-tipped catheters in the right atrium and aorta. After 10 minutes of left anterior descending coronary artery balloon obstruction, followed by 8 minutes of untreated VF, animals were randomized to immediate defibrillation (DEFIB 1st) or 3 minutes of pre-shock CPR (CPR 1st). Standard ACLS was otherwise provided, and surviving animals were observed for 24 hours. The primary outcome measurement was 24-hour survival with good neurological outcome, defined as CPC-1 or 2 (Good Neuro).
Results: The two groups did not differ in baseline weight, hemoglobin, blood gases, or hemodynamics. CPR 1st resulted in a lower rate of Good Neuro outcome (Table⇓).
Conclusions: Pre-shock CPR worsened outcome from VF during the circulatory phase in this swine model with acute left anterior descending coronary artery obstruction.