Study of the effects of 3 h of continuous cardiopulmonary resuscitation at 27°C on global oxygen transport and organ blood flow
Permanent link
https://hdl.handle.net/10037/18567Date
2020-04-16Type
Journal articleTidsskriftartikkel
Peer reviewed
Author
Nilsen, Jan Harald; Valkov, Sergei; Mohyuddin, Rizwan; Schanche, Torstein Lindahl; Kondratiev, Timofei V.; Næsheim, Torvind; Sieck, Gary C.; Tveita, TorkjelAbstract
Methods: Anesthetized pigs (n = 7) were immersion cooled to CA at 27°C. Predetermined variables were compared: (1) Before cooling, during cooling to 27°C with spontaneous circulation, after CA and subsequent continuous CPR (n = 7), vs. (2) before CA and during 45 min CPR in normothermic pigs (n = 4).
Results: When compared to corresponding values during spontaneous circulation at 38°C: (1) After 15 min of CPR at 27°C, cardiac output (CO) was reduced by 74%, mean arterial pressure (MAP) by 63%, DO2 by 47%, but organ blood flow was unaltered. Continuous CPR for 3 h maintained these variables largely unaltered except for significant reduction in blood flow to the heart and brain after 3 h, to the kidneys after 1 h, to the liver after 2 h, and to the stomach and small intestine after 3 h. (2) After normothermic CPR for 15 min, CO was reduced by 71%, MAP by 54%, and DO2 by 63%. After 45 min, hemodynamic function had deteriorated significantly, organ blood flow was undetectable, serum lactate increased by a factor of 12, and mixed venous O2 content was reduced to 18%.
Conclusion: The level to which CPR can replace CO and MAP during spontaneous circulation at normothermia was not affected by reduction in core temperature in our setting. Compared to spontaneous circulation at normothermia, 3 h of continuous resuscitation at 27°C provided limited but sufficient O2 delivery to maintain aerobic metabolism. This fundamental new knowledge is important in that it encourages early and continuous CPR in accidental hypothermia victims during evacuation and transport.
Is part of
Nilsen, J.H. (2022). Cardiopulmonary Resuscitation and Rewarming from Accidental Hypothermia. (Doctoral thesis). https://hdl.handle.net/10037/24126.
Valkov, S. (2023). Prolonged Cardiopulmonary Resuscitation in Accidental Hypothermia: Physiological and pathophysiological effects of cardiopulmonary resuscitation (CPR) in hypothermia regarding hemodynamics, oxygen transport and regional blood flow. (Doctoral thesis). https://hdl.handle.net/10037/31973.