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dc.contributor.authorNilsen, Jan Harald
dc.contributor.authorSchanche, Torstein Lindahl
dc.contributor.authorValkov, Sergey
dc.contributor.authorMohyuddin, Rizwan
dc.contributor.authorHåheim, Brage
dc.contributor.authorKondratyev, Timofey
dc.contributor.authorNæsheim, Torvind
dc.contributor.authorSieck, Gary C.
dc.contributor.authorTveita, Torkjel
dc.date.accessioned2021-11-25T07:28:40Z
dc.date.available2021-11-25T07:28:40Z
dc.date.issued2021-09-23
dc.description.abstractWe recently documented that cardiopulmonary resuscitation (CPR) generates the same level of cardiac output (CO) and mean arterial pressure (MAP) during both normothermia (38 °C) and hypothermia (27 °C). Furthermore, continuous CPR at 27 °C provides O2 delivery (ḊO2) to support aerobic metabolism throughout a 3-h period. The aim of the present study was to investigate the effects of extracorporeal membrane oxygenation (ECMO) rewarming to restore ḊO2 and organ blood flow after prolonged hypothermic cardiac arrest. Eight male pigs were anesthetized and immersion cooled to 27 °C. After induction of hypothermic cardiac arrest, CPR was started and continued for a 3-h period. Thereafter, the animals were rewarmed with ECMO. Organ blood flow was measured using microspheres. After cooling with spontaneous circulation to 27 °C, MAP and CO were initially reduced to 66 and 44% of baseline, respectively. By 15 min after the onset of CPR, there was a further reduction in MAP and CO to 42 and 25% of baseline, respectively, which remained unchanged throughout the rest of 3-h CPR. During CPR, ḊO2 and O2 uptake (V̇O2) fell to critical low levels, but the simultaneous small increase in lactate and a modest reduction in pH, indicated the presence of maintained aerobic metabolism. Rewarming with ECMO restored MAP, CO, ḊO2, and blood flow to the heart and to parts of the brain, whereas flow to kidneys, stomach, liver and spleen remained significantly reduced. CPR for 3-h at 27 °C with sustained lower levels of CO and MAP maintained aerobic metabolism sufficient to support ḊO2. Rewarming with ECMO restores blood flow to the heart and brain, and creates a “shockable” cardiac rhythm. Thus, like continuous CPR, ECMO rewarming plays a crucial role in “the chain of survival” when resuscitating victims of hypothermic cardiac arrest.en_US
dc.identifier.citationNilsen, Schanche, Valkov, Mohyuddin, Håheim, Kondratyev T.V., Næsheim, Sieck, Tveita. Effects of rewarming with extracorporeal membrane oxygenation to restore oxygen transport and organ blood flow after hypothermic cardiac arrest in a porcine model. Scientific Reports. 2021;11:18918:1-12en_US
dc.identifier.cristinIDFRIDAID 1943023
dc.identifier.doi10.1038/s41598-021-98044-2
dc.identifier.issn2045-2322
dc.identifier.urihttps://hdl.handle.net/10037/23160
dc.language.isoengen_US
dc.publisherNature Researchen_US
dc.relation.ispartofNilsen, J.H. (2022). Cardiopulmonary Resuscitation and Rewarming from Accidental Hypothermia. (Doctoral thesis). <a href=https://hdl.handle.net/10037/24126>https://hdl.handle.net/10037/24126</a>.
dc.relation.journalScientific Reports
dc.relation.projectIDinfo:eu-repo/grantAgreement/RCN/PETROMAX2/?/Norway/?/?/en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2021 The Author(s)en_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710en_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710en_US
dc.titleEffects of rewarming with extracorporeal membrane oxygenation to restore oxygen transport and organ blood flow after hypothermic cardiac arrest in a porcine modelen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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