Abstract 305: Remote Ischemic Postconditioning Alone and Combined with Therapeutic Hypothermia Improve Neurological Outcomes After Cardiopulmonary Resuscitation in a Porcine Model
Introduction: The degree of post-resuscitation cerebral injury is an important determinant on the outcomes for CA victims.We previously demonstrated remote ischemic pre- and post-conditioning equally attenuated post-CPR cerebral dysfunction in a rat model. Here we investigated the effects of remote ischemic post-conditioning (RIpostC) alone and combined with therapeutic hypothermia (TH) on the neurological outcomes after CPR.
Hypothesis: RIpostC would improve post-CPR neurological function and cerebral injury, which would be enhanced by its combination with TH.
Methods: Twenty-one male domestic pigs weighing 37 ± 2 kg were subjected to 10 mins of untreated VF followed by 5 mins of CPR. The animals were randomized to RIpostC, RIpostC+TH or control. Coincident with the start of CPR, RIpostC was induced by four cycles of 5 mins of limb ischemia followed by 5 mins of reperfusion. At 5 mins after resuscitation, TH was implemented by surface cooling to reach a temperature of 32-34 °C until 4 hrs post-resuscitation, followed by a rewarming rate of 1°C/h for 4 hrs. The resuscitated animals were observed for 72 hrs.
Results: Six of the seven animals in each group were successfully resuscitated. Significantly better neurological function was observed in the RIpostC group than in the control group. Surprisingly the combined RIpostC and TH further improved post-CPR neurological function, which was significantly better than that in the RIpostC and control groups. There was less cerebral injury in the animals that received RIpostC alone and combined with TH; which was significantly better at 48 and 72 hrs post-resuscitation when compared to the control group. Furthermore, significantly less cerebral injury was measured at 72 hrs in the combination group than in the RIpostC group (Table).
Conclusion: In a porcine model of CA, RIpostC significantly improved post-resuscitation neurological function and cerebral injury. Its combination with TH further enhanced its protective effects
Author Disclosures: J. Xu: None. S. Ye: None. Z. Li: None. M. Wang: None. Z. Wang: None. G. Chen: None. W. Tang: None.
- © 2014 by American Heart Association, Inc.