Abstract 56: Sodium Nitroprusside--Enhanced Cardiopulmonary Resuscitation Prevents Postresuscitation Left Ventricular Dysfunction and Improves 24-Hour Survival and Neurological Function in a Porcine Model of Prolonged Untreated Ventricular Fibrillation
Background: Sodium nitroprusside-enhanced CPR, or SNPeCPR, consists of active compression decompression CPR with an impedance threshold device, abdominal compression, and intravenous sodium nitroprusside (SNP). We hypothesize that SNPeCPR will improve post resuscitation left ventricular function and neurological function compared to standard (S) CPR after 15 minutes of untreated ventricular fibrillation (VF) in a porcine model of cardiac arrest.
Methods: Pigs (n=22) anesthetized with isoflurane underwent 15 minutes of untreated VF, were then randomized to 6 minutes of S-CPR (n=11) or SNPeCPR (n=11) followed by defibrillation. The primary endpoints were neurologic function as measured by cerebral performance category (CPC) score and left ventricular ejection fraction.
Results: SNPeCPR increased 24-hour survival rates compared to S-CPR (10/11 versus 5/11, p=0.03) and improved neurological function (CPC score 2.5±1, versus 3.8±0.4, respectively, p=0.004). Left ventricular ejection fractions at 1, 4 and 24 hours after defibrillation were 72±11, 57±11.4 and 64±11 with SNPeCPR versus 29±10, 30±17 and 39±6 with S-CPR, respectively (p<0.01 for all).
Conclusions: In pigs, after 15 minutes of untreated VF, SNPeCPR significantly improved 24-hour survival rates, neurologic function and prevented post-resuscitation left ventricular dysfunction.
- © 2011 by American Heart Association, Inc.