The effects of pre-arrest heparin administration dose for cardiac arrest model using extracorporeal lung and a heart assist (ECLHA) in dogs

Ichinose, Keisuke; Okamoto, Taisuke; Tashiro, Masafumi; Tanimoto, Hironari; Terasaki, Hidenori

doi:10.1016/j.resuscitation.2005.07.027

Cited by 12 publications

(7 citation statements)

References 28 publications

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“…32,33 In the face of absent pre-arrest heparinization, post-ischaemic regeneration of the animals was undisturbed and complete at the end of the seven-day observation period. Thus, the reported positive heparin effects on survival and neurological recovery or cardiac protection 12,13 might be of no significance in this setting. All organ systems showed vital function after CA and during the recovery period.…”

Section: Discussionmentioning

confidence: 93%

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Prolonged cardiac arrest and resuscitation by extracorporeal life support: favourable outcome without preceding anticoagulation in an experimental setting

Foerster¹,

D’Inka²,

Beyersdorf³

et al. 2013

Perfusion

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State-of-the-art cardiopulmonary resuscitation (CPR) restores circulation with inconsistent blood-flow and pressure. Extracorporeal life support (ECLS) following CPR opens the opportunity for "controlled reperfusion". In animal experiments investigating CPR with ECLS, systemic anticoagulation before induced cardiac arrest is normal, but a major point of dispute, since preliminary heparinization in patients undergoing unwitnessed cardiac arrest is impossible. In this study, we investigated options for ECLS after an experimental 15 minutes normothermic cardiac arrest, without preceding anticoagulation, in pigs. Neurological recovery was assessed by a scoring system, electroencephalography and brain magnetic resonance imaging. Additionally, brain histology was performed on day seven after cardiac arrest. We demonstrated that preliminary heparin administration was not necessary for survival or neurological recovery in this setting. Heparin flushing of the cannulae seemed sufficient to avoid thrombus formation. These findings may ease the way to using ECLS in patients with sudden cardiac arrest.

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Section: Discussionmentioning

confidence: 93%

“…11 Pre-arrest heparin administration can improve survival and neurological recovery after experimental CA and shows cardioprotective effects during reperfusion. 12,13…”

Section: Introductionmentioning

confidence: 99%

Prolonged cardiac arrest and resuscitation by extracorporeal life support: favourable outcome without preceding anticoagulation in an experimental setting

Foerster¹,

D’Inka²,

Beyersdorf³

et al. 2013

Perfusion

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“…However, Pytte and colleagues [29] demonstrated that pre-CA anticoagulation with enoxaparin (1 mg/kg) had no influence on hemodynamics or the return of spontaneous circulation after CPR-ALS after 10 minutes of untreated VF. In addition, much larger pre-CA heparin doses (700 IU/kg) were needed to produce favorable effects on survival and neurologic recovery in dogs subjected to 15 minutes of normothermic VF and CPB [30]. Finally, the alternative use of vasopressin and amiodarone (instead of epinephrine and lidocaine), which is equally recommended by the American Heart Association advanced cardiac life support algorithm, may have further improved the ROSC and post-CA outcomes observed in our model.…”

Section: Commentmentioning

confidence: 94%

Resuscitation After Prolonged Cardiac Arrest: Role of Cardiopulmonary Bypass and Systemic Hyperkalemia

Liakopoulos

Allen

Hristov

et al. 2010

The Annals of Thoracic Surgery

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Background. The purpose of this study was to determine (1) the role of emergency cardiopulmonary bypass (CPB) after prolonged cardiac arrest and failed cardiopulmonary resuscitation, and (2) the use of systemic hyperkalemia during CPB to convert intractable ventricular fibrillation (VF).Methods. Thirty-one pigs (34 ؎ 2 kg) underwent 15 minutes of cardiac arrest after induced VF, followed by 10 minutes of cardiopulmonary resuscitation-advanced life support. Peripheral CPB was used if cardiopulmonary resuscitation failed to restore stable circulation. Damage was assessed by evaluating hemodynamics, biochemical variables (creatine kinase-MB, neuron-specific enolase), neurologic deficit score, and brain magnetic resonance imaging.Results. Cardiopulmonary resuscitation alone was successful in only 19% (6 of 31 pigs). Cardiopulmonary bypass was initiated in 81% of animals (25 of 31 pigs) either for hypotension (5 of 25 pigs) or intractable VF (20 of 25 pigs). Defibrillation was successful in 7 of 20 animals during the first 10 minutes after initiating CPB.

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“…35 (3) We used heparin for systemic pre-arrest anticoagulation, but heparin potentially shows cardioprotective effects and can improve survival and neurologic recovery after experimental CA. 36,37 We examined this major point of objection in a small case study where we performed the same ECLS experiments without preceding anticoagulation. In summary, we found no positive effect of heparin in regard to survival or neurologic recovery (in press).…”

Section: Commentmentioning

confidence: 99%

Superior neurologic recovery after 15 minutes of normothermic cardiac arrest using an extracorporeal life support system for optimized blood pressure and flow

Trummer

Foerster

et al. 2013

Perfusion

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The effects of pre-arrest heparin administration dose for cardiac arrest model using extracorporeal lung and a heart assist (ECLHA) in dogs

Cited by 12 publications

References 28 publications

Prolonged cardiac arrest and resuscitation by extracorporeal life support: favourable outcome without preceding anticoagulation in an experimental setting

Prolonged cardiac arrest and resuscitation by extracorporeal life support: favourable outcome without preceding anticoagulation in an experimental setting

Resuscitation After Prolonged Cardiac Arrest: Role of Cardiopulmonary Bypass and Systemic Hyperkalemia

Superior neurologic recovery after 15 minutes of normothermic cardiac arrest using an extracorporeal life support system for optimized blood pressure and flow

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