Abstract 45: The Potential Mechanism of Sudden Increase in Intracranial Pressure During Initial Cardiac Arrest
Introduction: Intracranial pressure (ICP) plays an important role in neurological outcome following cardiac arrest. However, the dynamic changes of ICP during the early stages of cardiac arrest are still unknown. This study was to investigate the changes of ICP during ventricular fibrillation (VF) in the pig model of cardiac arrest and resuscitation. We hypothesized that there is an early increase in ICP and it may be related to elevation of central venous pressure during the initial period of cardiac arrest.
Methods: VF was electrically induced and untreated for 10 mins in 15 pigs weighing 38 ± 1 kg. ICP was assessed with a multi-parameter monitor (MPM-1, Integra Neurosciences) after insertion of a pressure sensor into brain parenchyma. Jugular venous pressure (JVP) was also continuously measured and recorded.
Results: The baseline ICP (17.6±4.1 mmHg) was greater than JVP (10.3±2.7 mmHg). Both ICP and JVP rose abruptly 3 mins after VF to 27.5±3.4, and 21.1±3.7 mmHg, respectively. The rises in ICP and JVP were gradually reduced in the following 7 mins. However, the patterns of fluctuation were similar. The changes of ICP correlated highly with that of JVP (r=0.819, p<0.01) (Fig. 2).
Conclusion: There is a rapid elevation in ICP during the early stages of cardiac arrest. This may result from the increased central venous pressure. Fig. 1. Intracranial pressure (ICP) during VF. Fig. 2. Correlation between intracranial pressure (ICP) and jugular venous pressure (JVP) during VF.
- © 2010 by American Heart Association, Inc.