Abstract 2504: Emergency Preservation and Resuscitation for Normovolemic Cardiac Arrest: Influence of Cold and Warm Aortic Flush on Neurologic Outcome After Prolonged Normovolemic Cardiac Arrest in Pigs
Background: Deep cerebral hypothermia via ice cold saline aortic flush during cardiac arrest (CA) just before resuscitation (EPR = Emergency Preservation and Resuscitation) and resuscitation with cardiopulmonary bypass (CPB) improved neurologic outcome in pigs. We hypothesised that less deep hypothermia by ice cold saline aortic flush without the use of CPB will also improve neurological outcome after 15 min of CA compared to a normothermic flush and conventional resuscitation according to guidelines.
Methods: Female pigs (29 –38kg) were put into ventricular fibrillation CA for 15 min. Pigs were subjected to conventional resuscitation according to guidelines (n=8); or mild hypothermia induced with a cold saline aortic flush (30ml/kg; n=8); or normothermia with application of a 38.5°C saline aortic flush (30ml/kg; n=8) at the beginning of resuscitation efforts. Defibrillation attempts were started at 17 min after induction of cardiac arrest. After return of spontaneous circulation mild therapeutic hypothermia (34.5°C) was continued for 20 h and intensive care for 9 days in all groups. Final evaluation included neurologic deficit scores
Conclusions: EPR with hypothermic or normothermic flush improved non-significantly survival and neurological outcome compared to conventional resuscitation. Compared to the former experiments where a higher volume flush, lower temperatures and CPB was used, we found a decreased survival and neurological outcome.