Abstract 75: Cold Saline Infusion Initiated During CPR and Continued Following Return of Spontaneous Circulation Does Not Impair Resuscitation Nor Induce Heart Failure by Volume Overload After Cardiac Arrest
Background: Cold saline intravenous infusion (CSI) is now recognized as a rapid method for inducing hypothermia following resuscitation from cardiac arrest. However, CSI initiated during CPR might cause decreases in coronary perfusion pressure (CPP) by volume loading an ischemic right ventricle, leading to increases in right atrial pressure. We explored the effects of CSI on CPP, resuscitation and myocardial function. We hypothesized that CSI would not impair resuscitation nor myocardial function after cardiac arrest.
Methods: Ventricular fibrillation was induced in 10 pigs, 38 ± 1 kg, and untreated for 10 mins. CPR, including mechanical chest compression/decompression with LUCAS device, ventilation and epinephrine, was then performed for 5 mins prior to defibrillation. Coincident with the start of CPR, animals were randomized into: 1. systemic cooling by CSI (30 mL/kg 4°C, in 30 mins) followed by surface cooling with a water blanket for 4 hrs; or 2. Control. Aortic and right atrial pressures and CPP were continuously measured, together with rectal temperature. Myocardial function was echocardiographically assessed.
Results: All the animals with the exception of one control were successfully resuscitated. CPP during CPR was equivalent among animals subjected to CSI or control (Table). Following resuscitation, right atrial pressure was significantly higher in animals subjected to CSI compared to control animals. However, mean and diastolic arterial pressures and myocardial function were not impaired (Table and Figure).
Conclusions: Cold saline infusion initiated during CPR did not decrease CPP nor impair resuscitation nor post resuscitation myocardial function.
- © 2010 by American Heart Association, Inc.