Lisa Barones Lisa Barones Wolfgang Weihs Wolfgang Weihs Alexandra Schratter Alexandra Schratter Andreas Janata Andreas Janata Petra Kodajova Petra Kodajova Helga Bergmeister Helga Bergmeister Lukas Kenner Lukas Kenner Michael Holzer Michael Holzer Wilhelm Behringer Wilhelm Behringer Sandra Högler Sandra Högler Nature Portfolio 2025 This study aims to retrospectively compare two resuscitation methods (extracorporeal cardiopulmonary resuscitation (ECPR) vs. emergency preservation and resuscitation (EPR)) by pathohistologically assessing pig brains in a ventricular fibrillation cardiac arrest (VFCA) model. In prospective studies from 2004 to 2006, swine underwent VFCA for 13 (n = 6), 15 (n = 14) or 17 (n = 6) minutes with ECPR (ECPR13, ECPR15 and ECPR17). Another 15 min VFCA group (n = 8) was resuscitated with EPR and chest compressions (EPR15 + CC). Brains of animals surviving for nine days (ECPR13 n = 4, ECPR15 n = 2, ECPR17 n = 1, EPR15 + CC n = 7) were harvested. Eight different brain regions were analyzed with the image analysis software QuPath using HE-staining, GFAP- and Iba1-immunohistochemistry. Only ECPR13 and EPR15 + CC animals were included in statistical analysis, due to low survival rates in the other groups. All VFCA samples showed significantly fewer viable neurons compared to shams, but no significant differences between ECPR13 and EPR15 + CC animals were observed. ECPR13 animals showed significantly more glial activation in all cerebral cortex regions compared to shams and in occipital, temporal and parietal cortex compared to EPR15 + CC. In conclusion, EPR + CC resulted in a significantly reduced inflammatory reaction in cerebral cortex compared to ECPR but did not influence the extent of neuronal death after VFCA. PDFDocument eng 2025-04-28T09:14:26.758738Z 2025 Animals Ventricular Fibrillation Therapy Ventricular Fibrillation Pathology Ventricular Fibrillation Complications Heart Arrest Therapy Heart Arrest Pathology Cerebral Cortex Pathology Cerebral Cortex Metabolism Swine Cardiopulmonary Resuscitation Methods Neurons Pathology Inflammation Pathology Disease Models, Animal Aorta Cold Temperature 4296059 b application/pdf http://creativecommons.org/licenses/by/4.0/