Abstract 127: Severity of Postresuscitation Myocardial Dysfunction Is Dependent on the Duration of Untreated Cardiac Arrest
Introduction: The duration of untreated ventricular fibrillation (VF) is one of the major determinant for outcome of cardiac arrest (CA). We investigated the relationship between different durations of untreated VF and post-resuscitation myocardial dysfunction and survival in a pig model.
Methods: An established model of myocardial infarction followed by CA and CPR was used. Twenty pigs(35-43 Kg) were subjected to 3 different untreated VF intervals, prior to mechanical CPR and defibrillation: 8-10 min; 12-13 min; or 14-15 min. Arterial and central venous pressures were invasively monitored. Ejection fraction (EF) was echocardiographically assessed together with termodilution cardiac output (CO) and high sensitivity cardiac troponin T (hs-cTnT) assay. Ninety six hr survival was evaluated.
Results: All the animals were resuscitated, except for 2 in the 14-15 min VF duration (Table). More than 80% of animals survived when the duration of VF was below 13 min, compared to only 17% after 14-15 min (Fig A). The duration of untreated VF correlated with the number of defibrillations required prior to resuscitation (r=0.60, p=0.01, Table). Longer durations of VF were characterized by higher post-resuscitation heart rate and right atrium pressure and by lower post-resuscitation CO and EF (p<0.01, Table). Ninety six hr EF recovered in all animals except in the pig that survived after 14-15 min VF. EF correlated with the number of defibrillation delivered (Fig B) and with hs-cTnT release (r=-0.84, p<0.0001).
Conclusions: In this model, post-resuscitation myocardial dysfunction and survival were affected by the duration of untreated VF in a time-dependent manner.
Author Disclosures: I. Russo: None. R. Affatato: None. S. Ceriani: None. A. Secomandi: None. F. Fumagalli: None. D.D. Zani: None. D. Novelli: None. T. Letizia: None. M. Di Giancamillo: None. S. Masson: None. R. Latini: None. L. Staszewsky: None. G. Ristagno: Other Research Support; Modest; Fondazione Sestini, Bergamo, Italy.
- © 2014 by American Heart Association, Inc.