Abstract 330: Impact of High-Volume, Continuous Venovenous Hemofiltration on Survival of Rats Resuscitated by Cardiopulmonary Bypass After Cardiac Arrest
Introduction: Some groups have reported a favorable impact of continuous venovenous hemofiltration (HF) on victims suffering lethal CA, yet whether it is better to use higher or standard volumes of HF is unclear.
Objective: To demonstrate the effects of two differing volumes of HF on post cardiac arrest syndrome (PCAS) and mortality in rodent models.
Methods: Twenty-four rats were randomly assigned into 3 groups; control, standard volume HF, or high volume (HV) HF. Animals were subjected to asphyxial CA for 12min, and then cardiopulmonary bypass (CPB) was employed for 30min as a resuscitation method. No inotropic and vasoactive drugs were injected. HF was employed with CPB and maintained for 6hr under normothermic conditions. The filtration volume was set at 35-45mL/kg/h in standard volume HF group and 105-135mL/kg/h in HV-HF group. Survival time was the primary outcome, and neurological deficit score at 7hr, hemodynamical status, blood levels of IL-6, TNFα, and lactate were measured as the secondary outcomes. Blood samples were obtained at baseline, 30min, 1hr, 2hr, 3hr, and 6hr after CPB.
Results: All animals gained ROSC by CPB and survived over 6hr but died within 24hr. There were no significant differences in survival time (long rank, control vs. HF; p=0.89, control vs. HV-HF; p=0.33) and in neurological deficit score (ANOVA, p=0.14). Mean TNFα levels increased but peaked out over time (peak was at 1hr, 78±57pg/mL, 82±85pg/mL, and 122±131pg/mL in control, HF, and HV-HF group), while mean IL-6 levels continued increasing over time (maximum was at 6hr, 3,795±6,401pg/mL, 9,839±11,720pg/mL, and 8,132±11,717pg/mL, respectively). IL-6 levels in HF and HV-HF groups were slightly higher than control group, however there were no significant differences in either cytokine levels. Blood pressure during and after CPB increased in all animals at 15min through 45min after CPB resuscitation. Mean blood pressure of control and HF groups were significantly higher than HV-HF group (p<0.01), raising the question of whether HV-HF removed vasoactive amines. There were no differences in any of the other secondary outcomes.
Conclusions: Neither standard volume nor high volume HF after CA had any effect on mortality, TNFα, nor IL-6 levels in severe PCAS models.
Author Disclosures: K. Shinozaki: None. T. Yin: None. W. Zhang: None. T. Da: None. J. Kim: None. J. Lampe: Employment; Significant; University of Pennsylvania. Research Grant; Significant; Sponsored research agreement with ZOLL Medical Corp. Other Research Support; Significant; NIH funding in resuscitation. Ownership Interest; Significant; Intellectual property in resuscitation devices. S. Oda: None. H. Hirasawa: None. L. Becker: Employment; Significant; University of Pennsylvania. Research Grant; Significant; Philips Medical Systems, NIH, BeneChill Inc., Zoll Medical Corp, Medtronic Foundation. Ownership Interest; Significant; Helar Technology. Consultant/Advisory Board; Significant; Philips Medical Systems, NIH Data Safety Monitoring Board, Helar Technology. Other; Significant; Volunteer member of the American Heart Association, Universities for Lecturing of Keio University.
- © 2014 by American Heart Association, Inc.