Abstract 14861: Relationship Between Hemodynamic Parameters and Brain Blood Flow During Cardiopulmonary Resuscitation
Introduction: Cerebral blood flow during CPR is difficult to assess. Consequently, the key hemodynamic determinants of cerebral perfusion during CPR remain poorly understood. We recently demonstrated that changes in the head position (flat, up, and down) during CPR significantly affected brain blood flow. The effect of head position was consistent in different regions of the brain, as shown in the figure.
Hypothesis: We hypothesized that a single routinely measured hemodynamics parameter correlated well with cerebral brain flow during CPR regardless of the head position.
Methods: Brain blood flow, determined by microsphere techniques, was measured in eight pigs during CPR performed using an automated CPR device together with an impedance threshold device in the flat or supine (SUP), whole body head down (HDT) and whole body head up (HUT) tilt positions. Using random-intercept linear regression, we estimated β coefficients adjusted for head position between overall brain flow and key hemodynamic parameters, including arterial blood pressure (ABP), right atrial pressure (RAP), intracranial pressure (ICP), EtCO2, carotid blood flow (CBF), calculated cerebral (CerPP) and coronary perfusion pressure (CPP). P-values of less than 0.05 were considered significant.
Results: Head position-adjusted β regression coefficient estimates for diastolic ABP, EtCO2, minimum and mean CerPP were 0.010 (standard error (SE) = 0.003, p<0.001), 0.005 (SE = 0.003, p=0.04), 0.005 (SE = 0.002, p=0.02) and 0.006 (SE = 0.003, p=0.02), respectively to predict brain blood flow. RAP, ICP and CBF were not associated with brain flow measurement. Head position did not remain significantly associated with brain blood flow after entering mean CerPP into the linear regression model.
Conclusions: Mean CerPP was highly correlated with brain blood flow during CPR, regardless of the position of the head. Further study is needed to replicate this finding.
Author Disclosures: G. Debaty: None. J. Labarere: None. J. Moore: None. H. Ryu: None. K. Lurie: Consultant/Advisory Board; Significant; consultant to manufacturer of device used in study.
- © 2016 by American Heart Association, Inc.