Abstract 172: Erythropoietin Given During CPR Improves Post-Resuscitation Myocardial Function
Objective: We previously reported in rats that a single bolus dose of erythropoietin (EPO) given at the start of CPR enhanced the hemodynamic efficacy of chest compression by attenuating decreases in left ventricular distensibility. In a pilot clinical study, this effect translated into higher resuscitation rates. However, survival rates exceeded projections based on initial resuscitation, suggesting the possibility of additional post-resuscitation benefits. We therefore investigated in a rat model of VF whether a single bolus dose of EPO given at the start of CPR could also elicit beneficial effects on post-resuscitation myocardial function.
Methods: VF was electrically induced in male adult rats and left untreated for 8 minutes before attempting resuscitation by 8 minutes of CPR and electrical shocks. Rats were randomized to receive 5,000 U/kg (n = 5) or saline vehicle (n=5) into the right atrium immediately before starting CPR with the investigators blind to the assignment. All rats restored spontaneous circulation and were treated for 120 minutes with 0.9% NaCl infusion (24 ml/kg/hr) for preload support and dobutamine (15 μg/kg/min) for inotropic support.
Results: Administration of EPO markedly improved post-resuscitation myocardial function evidenced by progressive increases in cardiac work index (CWI) as shown in Figure. This effect was accompanied by increases in cardiac index (160 ± 6 vs 124 ± 18 ml/min/kg, p = 0.025), stroke volume index (0.406 ± 0.01 vs 0.307 ± 0.04 ml/beat/kg, p = 0.023), and mean aortic pressure (99 ± 2 vs 83 ± 8 mmHg, p = 0.007); mean ± SEM at 120 minutes post-resuscitation.
Conclusions: A single bolus dose of EPO given at the start of CPR exerted beneficial myocardial effects that manifested post-resuscitation by progressive improvement in myocardial and hemodynamic function; an effect that could explain survival greater than expected based solely on the initial resuscitation effect.
- © 2010 by American Heart Association, Inc.