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dc.contributor.authorValkov, Sergei
dc.contributor.authorNilsen, Jan Harald
dc.contributor.authorMohyuddin, Rizwan
dc.contributor.authorSchanche, Torstein Lindahl
dc.contributor.authorKondratyev, Timofey
dc.contributor.authorSieck, Gary C.
dc.contributor.authorTveita, Torkjel
dc.date.accessioned2022-11-22T12:48:30Z
dc.date.available2022-11-22T12:48:30Z
dc.date.issued2022-06-09
dc.description.abstractIntroduction: Victims of accidental hypothermia in hypothermic cardiac arrest (HCA) may survive with favorable neurologic outcome if early and continuous prehospital cardiopulmonary resuscitation (CPR) is started and continued during evacuation and transport. The efficacy of cerebral autoregulation during hypothermic CPR is largely unknown and is aim of the present experiment.<p> <p>Methods: Anesthetized pigs (n = 8) were surface cooled to HCA at 27°C before 3 h continuous CPR. Central hemodynamics, cerebral O<sub>2</sub> delivery (DO<sub>2</sub>) and uptake (VO<sub>2</sub>), cerebral blood flow (CBF), and cerebral perfusion pressure (CPP) were determined before cooling, at 32°C and at 27°C, then at 15 min after the start of CPR, and hourly thereafter. To estimate cerebral autoregulation, the static autoregulatory index (sARI), and the CBF/VO<sub>2</sub> ratio were determined.<p> <p>Results: After the initial 15-min period of CPR at 27°C, cardiac output (CO) and mean arterial pressure (MAP) were reduced significantly when compared to corresponding values during spontaneous circulation at 27°C (−66.7% and −44.4%, respectively), and remained reduced during the subsequent 3-h period of CPR. During the first 2-h period of CPR at 27°C, blood flow in five different brain areas remained unchanged when compared to the level during spontaneous circulation at 27°C, but after 3 h of CPR blood flow in 2 of the 5 areas was significantly reduced. Cooling to 27°C reduced cerebral DO2 by 67.3% and VO<sub>2</sub> by 84.4%. Cerebral VO<sub>2</sub> was significantly reduced first after 3 h of CPR. Cerebral DO<sub>2</sub> remained unaltered compared to corresponding levels measured during spontaneous circulation at 27°C. Cerebral autoregulation was preserved (sARI > 0.4), at least during the first 2 h of CPR. Interestingly, the CBF/VO<sub>2</sub> ratio during spontaneous circulation at 27°C indicated the presence of an affluent cerebral DO<sub>2</sub>, whereas after CPR, the CBF/VO<sub>2</sub> ratio returned to the level of spontaneous circulation at 38°C.<p> <p>Conclusion: Despite a reduced CO, continuous CPR for 3 h at 27°C provided sufficient cerebral DO<sub>2</sub> to maintain aerobic metabolism and to preserve cerebral autoregulation during the first 2-h period of CPR. This new information supports early start and continued CPR in accidental hypothermia patients during rescue and transportation for in hospital rewarming.en_US
dc.identifier.citationValkov, Nilsen, Mohyuddin, Schanche, Kondratyev, Sieck, Tveita. Autoregulation of Cerebral Blood Flow During 3-h Continuous Cardiopulmonary Resuscitation at 27°C. Frontiers in Physiology. 2022;13en_US
dc.identifier.cristinIDFRIDAID 2056716
dc.identifier.doi10.3389/fphys.2022.925292
dc.identifier.issn1664-042X
dc.identifier.urihttps://hdl.handle.net/10037/27468
dc.language.isoengen_US
dc.publisherFrontiers Mediaen_US
dc.relation.ispartofValkov, 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). <a href=https://hdl.handle.net/10037/31973 >https://hdl.handle.net/10037/31973 </a>.
dc.relation.journalFrontiers in Physiology
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2022 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleAutoregulation of Cerebral Blood Flow During 3-h Continuous Cardiopulmonary Resuscitation at 27°Cen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Except where otherwise noted, this item's license is described as Attribution 4.0 International (CC BY 4.0)