Neuroprotection with hypothermic reperfusion and extracorporeal cardiopulmonary resuscitation - A randomized controlled animal trial of prolonged ventricular fibrillation cardiac arrest in rats

Ingrid Magnet; Alexandra-Maria Stommel; Christoph Schriefl; Matthias Mueller; Michael Poppe; Juergen Grafeneder; Christoph Testori; Andreas Janata; Andreas Schober; Daniel Grassmann; Wilhelm Behringer; Wolfgang Weihs; Michael Holzer; Sandra Hoegler; Florian Ettl

doi:10.1177/0271678X241281485

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Title (eng)

Neuroprotection with hypothermic reperfusion and extracorporeal cardiopulmonary resuscitation - A randomized controlled animal trial of prolonged ventricular fibrillation cardiac arrest in rats

Author

Ingrid Magnet

Alexandra-Maria Stommel

Christoph Schriefl

Matthias Mueller

Michael Poppe

Juergen Grafeneder

Christoph Testori

Andreas Janata

Andreas Schober

Daniel Grassmann

Wilhelm Behringer

Wolfgang Weihs

Michael Holzer

Sandra Hoegler

University of Veterinary Medicine Vienna

Florian Ettl

Abstract (eng)

Extracorporeal cardiopulmonary resuscitation (ECPR) facilitates resuscitation with immediate and precise temperature control. This study aimed to determine the optimal reperfusion temperature to minimize neurological damage after ventricular fibrillation cardiac arrest (VFCA). Twenty-four rats were randomized (n = 8 per group) to normothermia (NT = 37°C), mild hypothermia (MH = 33°C) or moderate hypothermia (MOD = 27°C). The rats were subjected to 10 minutes of VFCA, before 15 minutes of ECPR at their respective target temperature. After ECPR weaning, rats in the MOD group were rapidly rewarmed to 33°C, and temperature maintained at 33°C (MH/MOD) or 37°C (NT) for 12 hours before slow rewarming to normothermia (MH/MOD). The primary outcome was 30-day survival with overall performance category (OPC) 1 or 2 (1 = normal, 2 = slight disability, 3 = severe disability, 4 = comatose, 5 = dead). Secondary outcomes included awakening rate (OPC ≤ 3) and neurological deficit score (NDS, from 0 = normal to 100 = brain dead). The survival rate did not differ between reperfusion temperatures (NT = 25%, MH = 63%, MOD = 38%, p = 0.301). MH had the lowest NDS (NT = 4[IQR 3–4], MH = 2[1–2], MOD = 5[3–5], p = 0.044) and highest awakening rate (NT = 25%, MH = 88%, MOD = 75%, p = 0.024). In conclusion, ECPR with 33°C reperfusion did not statistically significantly improve survival after VFCA when compared with 37°C or 27°C reperfusion but was neuroprotective as measured by awakening rate and neurological function.

Keywords (eng)

AnimalsVentricular Fibrillation TherapyCardiopulmonary Resuscitation MethodsHypothermia, Induced MethodsMaleHeart Arrest TherapyHeart Arrest ComplicationsRatsNeuroprotectionRats, Sprague-DawleyExtracorporeal Membrane Oxygenation MethodsReperfusion MethodsDisease Models, Animal

Type (eng)

journal article

Language

[eng]

Persistent identifier

https://phaidra.vetmeduni.ac.at/o:3970

DOI

10.1177/0271678X241281485

Is in series

Title (eng)

Journal of Cerebral Blood Flow and Metabolism

Volume