Comparison of hemodynamic effects and resuscitation outcomes between automatic simultaneous sterno-thoracic cardiopulmonary resuscitation device and LUCAS in a swine model of cardiac arrest

Cha, Kyoung‐Chul; Kim, Hyung Il; Kim, Yongwon; Ahn, Gyo Jin; Kim, Yoon Seob; Kim, Sun-Ju; Lee, Jun Hyuk; Hwang, Sung Oh

doi:10.1371/journal.pone.0221965

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…First, we were unable to stratify the types of CPR interventions due to the heterogeneity of CPR interventions (including defibrillation, anti-arrhythmic drugs, adrenergic drugs, and mechanical CPR). Efforts were made to provide specific information in each article in Supplementary Material B [40–256] to identify the type of VF induction used in the experiment of interest. Second, the quality of the included studies was not assessed.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of swine models for ventricular fibrillation induction in evaluating cardiopulmonary resuscitation methods

Low,

Azahar,

Samson

et al. 2024

Cardiology Plus

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Background and purpose: Ventricular fibrillation (VF) has been studied using a variety of swine models, historically balloon occlusion of the coronary artery and asphyxiation, and more recently, percutaneous electrical induction. These methods differ in face and construct validity, as well as requirement for expertise, cost, and duration. This study aimed to provide a systematic review these methods and their selection in research. Methods: Electronic searches were conducted in PubMed, Scopus, and Google Scholar. The Utstein-Style Guidelines for Uniform Reporting of Laboratory cardiopulmonary resuscitation (CPR) research were used to identify the extracted variables by two independent investigators. Discrepancy was resolved by discussion with the third investigator. Results: We included 236 studies published from 1990 to 2024. The most commonly used method was electrical induction using a pacing wire cannulated through the external jugular vein into the right ventricle (n = 112), followed by transthoracic electrical induction (n = 28), asphyxiation (n = 20), electrical induction via two subcutaneous needles (n = 15), and balloon occlusion (n = 10). The mean and standard deviation (SD) of the untreated VF duration were 6.9 and 5.0 minutes, respectively. Female and male pigs were used exclusively in 52 and 45 studies, respectively; both sexes were used in 31 studies; 106 studies not reporting the sex. The mean weight of the pigs was 30.2 ± 12.4 kg in 209 studies, and the number of pigs used in the studies ranged from 2 to 271 with a median of 20 (interquartile range: 15–30) pigs in 223 studies. The four most commonly used drugs for anesthesia/preparation were ketamine (n = 145), propofol (n = 76), isoflurane (n = 68), and pentobarbital (n = 61), either alone or in combination. Higher current and voltage were used for less invasive methods. Conclusions: The two most common electric method to induce VF were invasive pacing at the right ventricle and non-invasive transthoracic electrical induction. Asphyxiation was the most common ischemic VF induction. The choice of the VF induction method depends on cost, expertise, feasibility, and the nature of the CPR intervention to be tested.

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Section: Discussionmentioning

confidence: 99%

Systematic review of swine models for ventricular fibrillation induction in evaluating cardiopulmonary resuscitation methods

Low,

Azahar,

Samson

et al. 2024

Cardiology Plus

View full text Add to dashboard Cite

show abstract

“…Rats were anesthetized with isoflurane and injected with 0.4 mL of subcutaneous anesthetic containing 69 mg/mL ketamine, 3.45 mg/mL xylazine, and 1.38 mg/mL acepromazine. The right internal carotid artery was exposed and cannulated via the standard approach and rats were placed in stereotactic head frame for nerve exposure [13,19,20].…”

Section: Methodsmentioning

confidence: 99%

Sphenopalatine Ganglion Stimulation Upregulates Transport of Temozolomide across the Blood-Brain Barrier

et al. 2020

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Sphenopalatine ganglion (SPG) stimulation has been shown to reversibly alter blood-brain barrier (BBB) permeability. It is widely used for the treatment of cluster headaches in Europe and is well tolerated in humans. The therapeutic potential for SPG stimulation in other central nervous system (CNS) diseases has yet to be explored. Glioblastoma Multiforme (GBM) remains one of the most difficult primary CNS neoplasms to treat, with an average survival of approximately 18 months at the time of diagnosis. Since 2004, the gold standard of treatment for GBM in the United States includes surgery followed by treatment with temozolomide (TMZ) and radiation. We sought to determine if SPG stimulation could increase chemotherapy concentrations in rodent brains with an intact BBB. Here, we show a statistically significant (p = 0.0006), five-fold upregulation of TMZ crossing the BBB and reaching brain parenchyma in rats receiving low-frequency (LF, 10 Hz) SPG stimulation. All the measurements were performed using a highly sensitive liquid chromatography mass spectrometry (LCMS) method that was developed for quantitation of TMZ in plasma and brain tissue. Our treatment paradigm shows novel delivery route by which we could more effectively and safely deliver TMZ in a targeted manner, to minimize systemic toxicity and maximize action at the target tissue.

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Effect of cardiopulmonary resuscitation on perfusion in a porcine model of severe hemorrhagic shock

Greiffenstein,

Cavalea,

Smith

et al. 2024

J Trauma Acute Care Surg

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BACKGROUND Pulseless electrical activity from hemorrhagic shock has not been shown to benefit from cardiopulmonary resuscitation (CPR). Using a porcine model, our objective was to determine the effects of CPR on brain and skin oxygenation as a measure of perfusion in the setting of severe hemorrhagic shock. METHODS Adult swine randomized to non-CPR and CPR were anesthetized. Tissue oxygen sensors were inserted into the parietal cerebral parenchyma and skin. Controlled hemorrhagic shock with mean arterial pressure (MAP) <30 mm Hg was achieved and allowed to persist for 10 minutes. Animals were randomized to either receive automated CPR or no treatment. They were then autotransfused with sufficient blood to achieve MAP >60 mm Hg. Measurements were obtained before, during, and after shock state. Outcomes were modeled using mixed-effects lognormal models. RESULTS A total of 12 swine were used, and the results were analyzed (non-CPR, n = 5; CPR, n = 7). One animal in the CPR group died during shock. One cerebral probe sensor malfunctioned, and these data were excluded. Baseline characteristics were similar between groups. MAP during shock was similar between groups; however, the CPR group had significantly higher systolic blood pressure (62.8 vs. 48.8 mm Hg, p = 0.010) and lower diastolic blood pressure (12.8 vs. 27.8 mm Hg, p < 0.001). Both cerebral (pBO2) and skin oxygenation (TcO2) dropped significantly as a result of shock. The CPR group had lower overall measures of tissue perfusion during shock, but only TcO2 at the shoulder was significantly lower during shock (11.5 vs. 21.1 mm Hg, p = 0.027) and recovery (33.3 vs. 62 mm Hg, p = 0.033). CONCLUSION Our model showed that adding CPR during hemorrhagic shock did not improve end-organ oxygenation/perfusion, but did significantly diminish skin perfusion. This experiment corroborates existing literature on the potential detrimental effects of CPR during hemorrhagic pulseless electrical activity, but further work is needed to confirm this observation.

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Comparison of hemodynamic effects and resuscitation outcomes between automatic simultaneous sterno-thoracic cardiopulmonary resuscitation device and LUCAS in a swine model of cardiac arrest

Cited by 3 publications

References 32 publications

Systematic review of swine models for ventricular fibrillation induction in evaluating cardiopulmonary resuscitation methods

Systematic review of swine models for ventricular fibrillation induction in evaluating cardiopulmonary resuscitation methods

Sphenopalatine Ganglion Stimulation Upregulates Transport of Temozolomide across the Blood-Brain Barrier

Effect of cardiopulmonary resuscitation on perfusion in a porcine model of severe hemorrhagic shock

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