Abstract 59: Relationship Between Duration of Untreated Cardiac Arrest and Neurological Dysfunction and Injury in a Porcine Model of Cardiac Arrest and CPR
Introduction: Relationship between untreated ventricular fibrillation (VF) and neuronal injury was investigated in a porcine model.
Methods: Twenty pigs (35-43kg) were subjected to 3 different durations of untreated VF: 8-10 min (n=8), 12-13 min (n=6), or 14-15 min (n=6), prior to mechanical CPR and defibrillation. Following resuscitation, blood samples were obtained for serum neuron specific enolase (NSE) assays. Animals were observed up to 96 hr for assessment of survival and neurological recovery. Brains were harvested for histopathology, biochemistry, and transmission electron microscopy.
Results: All the animals were resuscitated, except for 2 in the 14-15 min VF duration. More than 80% of animals survived when VF duration was < 13 min, compared to only 17% after 14-15 min. Neurological deficit score (NDS) increased and neurological alertness score (NAS) decreased concurrently with the increases in VF duration (Fig 1). NDS and NAS improved during the 96 hr in animals subjected to a VF < 13 min, while no improvement was observed for longer duration (Fig 1). Accordingly, animals subjected to longer VF presented a more severe neuronal loss and a significantly higher serum NSE (Fig 1). NSE (r<0.89, p<0.0001) and neuronal loss (r=0.79, p<0.001) were directly related to VF duration. Ultrastructural analysis showed damage of cytoplasmic mitochondria associated with abnormalities in the surrounding neuropil (Fig 2). Western blot analysis with anti-Iba1 antibody, a microglial marker, in hippocampal homogenate showed a progressive increase of the signal according to the VF duration.
Conclusions: Neurological injury was affected by the duration of untreated VF.
Author Disclosures: F. Fumagalli: None. M. De Maglie: None. C. Foray: None. V. Locatelli: None. C. Balducci: None. T. Letizia: None. J. Windheim: None. A. Frasca: None. F. Fiordaliso: None. S. Masson: None. D. Pravettoni: None. G. Forloni: None. R. Latini: None. E. Scanziani: None. A. Belloli: None. M.B. Skrifvars: Research Grant; Modest; Laerdal Foundation for Acute, Norway Medicine. G. Ristagno: None.
- © 2014 by American Heart Association, Inc.