Τίτλος:
Correlation of Impedance Threshold Device use during cardiopulmonary resuscitation with post-cardiac arrest Acute Kidney Injury
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Niforopoulou, P.
Iacovidou, N.
Lelovas, P.
Karlis, G.
Papalois, Α.
Siakavellas, S.
Spapis, V.
Kaparos, G.
Siafaka, I.
Xanthos, T.
Περιοδικό:
The American Journal of Emergency Medicine
Λέξεις-κλειδιά:
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
DOI:
10.1016/j.ajem.2017.01.040
