TY - JOUR
TI - Correlation of Impedance Threshold Device use during cardiopulmonary resuscitation with post-cardiac arrest Acute Kidney Injury
AU - Niforopoulou, P.
AU - Iacovidou, N.
AU - Lelovas, P.
AU - Karlis, G.
AU - Papalois, Α.
AU - Siakavellas, S.
AU - Spapis, V.
AU - Kaparos, G.
AU - Siafaka, I.
AU - Xanthos, T.
JO - The American Journal of Emergency Medicine
PY - 2017
VL - 35
TODO - 6
SP - 846-854
PB - W.B. Saunders
SN - 0735-6757
TODO - 10.1016/j.ajem.2017.01.040
TODO - interleukin 18;  neutrophil gelatinase associated lipocalin;  biological marker;  epinephrine;  interleukin 18;  neutrophil gelatinase associated lipocalin, acute kidney failure;  animal experiment;  animal model;  aortic pressure;  Article;  controlled study;  coronary artery blood flow;  CPR feedback device;  diastolic blood pressure;  experimental ventricular fibrillation;  female;  heart arrest;  impedance threshold device;  kidney blood flow;  life support equipment;  mean arterial pressure;  mechanical chest compressor;  nonhuman;  piglet;  priority journal;  protein blood level;  protein urine level;  resuscitation;  return of spontaneous circulation;  tidal volume;  acute kidney failure;  animal;  complication;  devices;  disease model;  heart arrest;  hemodynamics;  impedance;  physiologic monitoring;  pig;  resuscitation;  urine;  Ventricular Fibrillation, Acute Kidney Injury;  Animals;  Biomarkers;  Cardiopulmonary Resuscitation;  Disease Models, Animal;  Electric Impedance;  Epinephrine;  Female;  Heart Arrest;  Hemodynamics;  Interleukin-18;  Lipocalin-2;  Monitoring, Physiologic;  Swine;  Ventricular Fibrillation
TODO - Purpose To assess whether use of Impedance Threshold Device (ITD) during cardiopulmonary resuscitation (CPR) reduces the degree of post-cardiac arrest Acute Kidney Injury (AKI), as a result of improved hemodynamics, in a porcine model of ventricular fibrillation (VF) cardiac arrest. Methods After 8 min of untreated cardiac arrest, the animals were resuscitated either with active compression-decompression (ACD) CPR plus a sham ITD (control group, n = 8) or with ACD-CPR plus an active ITD (ITD group, n = 8). Adrenaline was administered every 4 min and electrical defibrillation was attempted every 2 min until return of spontaneous circulation (ROSC) or asystole. After ROSC the animals were monitored for 6 h under general anesthesia and then returned to their cages for a 48 h observation, before euthanasia. Two novel biomarkers, Neutrophil Gelatinase-Associated Lipocalin (NGAL) in plasma and Interleukin-18 (IL-18) in urine, were measured at 2 h, 4 h, 6 h, 24 h and 48 h post-ROSC, in order to assess the degree of AKI. Results ROSC was observed in 7 (87.5%) animals treated with the sham valve and 8 (100%) animals treated with the active valve (P = NS). However, more than twice as many animals survived at 48 h in the ITD group (n = 8, 100%) compared to the control group (n = 3, 37.5%). Urine IL-18 and plasma NGAL levels were augmented post-ROSC in both groups, but they were significantly higher in the control group compared with the ITD group, at all measured time points. Conclusion Use of ITD during ACD-CPR improved hemodynamic parameters, increased 48 h survival and decreased the degree of post-cardiac arrest AKI in the resuscitated animals. © 2017 Elsevier Inc.
ER -