Abstract 71: Treatment Of Post Resuscitation Left Ventricular Dysfunction Following Cardiac Arrest With Sodium Nitroprusside
Introduction: After cardiac arrest, post resuscitation global left ventricular (LV) dysfunction is a common cause of significant morbidity and mortality. We hypothesize that sodium nitroprusside (SNP) can rapidly improve LV function, decrease LV wall thickness and improve carotid blood flow after cardiac arrest.
Methods: 6 female pigs (30–32 kg), intubated and anesthetized with isoflurane, were studied after being successfully resuscitated from a prolonged ventricular fibrillation (VF) arrest that included10 min of no CPR, 6 min of CPR, and up to three 120 J DC biphasic defibrillation shocks. Aortic pressure and carotid blood flow were continuously recorded. LV function was assessed with intracardiac echocardiography 15 minutes after resuscitation. LV short and long axis views were analyzed. Subsequently, 1 mg of SNP was infused IV every 5 minutes and after 10 minutes LV function was measured again. Paired t-test was used for statistical analysis
Results: SNP significantly increased the post resuscitation LV ejection fraction [from (mean ±SD) 42±5 to 55±8%, p<0.05] and mean carotid blood flow (from 72±12 to 160±48 ml/min, p<0.05). SNP significantly decreased the end systolic LV diameter and septal wall thickness (from 1.35±0.2 and 1.3±0.1cm to 0.9±0.25 and 1.0±0.1cm, p<0.05). Mean aortic pressure was not significantly affected with the addition of SNP (from 72±14 to 66±18, p=ns).
Conclusions: Administration of large boluses of SNP (1 mg) improved LV ejection fraction, wall thickness and carotid blood flow without adversely affecting mean aortic pressure. SNP should be considered for the treatment of post resuscitation LV dysfunction.
- © 2010 by American Heart Association, Inc.