The hemodynamic and arterial blood gas response to asphyxiation: a canine model of pulseless electrical activity

DeBehnke, Daniel J.; Hilander, Swen J.; Dobler, Daniel W.; Wickman, Laurie L.; Swart, Gary L.

doi:10.1016/0300-9572(95)00873-r

Cited by 45 publications

(21 citation statements)

References 19 publications

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“…This characteristic pattern of mild tachycardia-hypertension -bradycardiahypotension has already been described in other asphyxial experimental studies. 32,49,50 In the present study we found that surviving animals had a higher HR compared with non-surviving animals. Until now no other study has reported similar findings.…”

Section: Discussionsupporting

confidence: 63%

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Asphyxial cardiac arrest, resuscitation and neurological outcome in a Landrace/Large-White swine model

et al. 2011

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The vast majority of laboratory studies on animals have focused on ventricular fibrillation (VF) and not on cardiac arrest (CA) resulting from asphyxia. The aim of this study was to develop a clinically relevant animal model in Landrace/Large-White swine of asphyxial CA resuscitated using the European Resuscitation Council guidelines. Survival and 24 h neurological outcome in terms of functional deficit were also evaluated. Asphyxial arrest was induced by clamping the endotracheal tube (ETT) in 10 Landrace/Large-White piglets. After 4 min of untreated arrest, resuscitation was initiated by unclamping the ETT, 100% oxygen mechanical ventilation, 2 min chest compressions and epinephrine administration. Advanced Life Support algorithm was followed. In case of restoration of spontaneous circulation, the animals were supported for one hour and then observed for 23 h. Coronary perfusion pressure was significantly higher in surviving animals (P , 0.001) during cardiopulmonary resuscitation. End-tidal CO 2 was significantly higher in the animals that survived than in non-surviving animals (P ¼ 0.001). All of the animals were severely neurologically impaired 24 h after CA. This refined model of asphyxia CA is easily reproducible and may be used for pharmacological studies in CA.

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Section: Discussionsupporting

confidence: 63%

“…In this model of asphyxial CA we established that by the end of the 4 min of untreated arrest, VF occurred in six out of 10 piglets. Even though, the rhythms in paediatric CA were thought to be asystole and bradydysrhythmias, 64,65 Walsh and Krongrad 66 first noted that VF could occur as a terminal rhythm in all paediatric age groups.…”

Section: Discussionmentioning

confidence: 99%

Asphyxial cardiac arrest, resuscitation and neurological outcome in a Landrace/Large-White swine model

et al. 2011

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“…The majority of pediatric arrests are asphyxial in origin, resulting from airway obstruction or failure of ventilation, with the most common pathophysiologic pathway being the progression from bradycardia with hypoperfusion to PEA and/or asystole. 2,[30][31][32] In this study, however, initial PEA rhythms were converted to VF rather than asystole during the cardiac arrest interval. This is in accordance with recent studies that show the incidence of VF as an initial outcome of out-of-hospital cardiac arrest rhythm appears to be increasing, 1,11,[33][34][35][36][37] especially in children 9 to 17 years of age.…”

Section: Discussionmentioning

confidence: 74%

“…[1][2][3][4] The majority of cardiac arrests in children result from respiratory failure secondary to upper or lower airway obstruction, with asystole usually being the initial cardiac arrest rhythm. 5 Unfortunately, most asphyxial arrests are not witnessed, and bystanders initiate cardiopulmonary resuscitation (CPR) in only 23% to 35% of cases.…”

mentioning

confidence: 99%

Intraarrest Rhythms and Rhythm Conversion in Asphyxial Cardiac Arrest

Varvarousi

Chalkias

Stefaniotou

et al. 2015

Academic Emergency Medicine

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Objectives:The objective was to analyze the cardiac arrest rhythms presenting during asphyxial cardiac arrest (ACA).Methods: Asphyxial cardiac arrest was induced in 30 Landrace large white piglets, aged 12 to 15 weeks and with a mean (AESD) weight of 20 (AE2) kg. After the onset of cardiac arrest, the animals were left untreated for 4 minutes, after which cardiopulmonary resuscitation was commenced. Heart rhythms were monitored from the onset of asphyxia until return of spontaneous circulation or death.

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“…Although blood pressure was not measured by Jauchem et al [15], it is possible that pulseless electrical activity was present in these animals. Asphyxiation can produce cardiac arrest due to pulseless electrical activity in a wide variety of both conscious and anesthetized animal models (discussed by DeBehnke et al [69]). Hypoxia and acidosis are both potential causes of pulseless electrical activity [70].…”

Section: Lack Of Effective Respiration: Does It Occur During Cew Applmentioning

confidence: 98%

Repeated or long-duration TASER® electronic control device exposures: acidemia and lack of respiration

Jauchem

2009

Forensic Sci Med Pathol

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Conducted energy weapons (CEWs), such as TASER devices, may be applied to subjects in repeated or long-duration modes. Such applications may result in more potentially harmful effects (as reflected in blood factor changes) than shorter exposures. In this review, results from a number of studies of repeated and long-duration CEW exposures in an animal model are examined. Additionally, a few limited investigations of shorter CEW applications to human subjects are considered. Specifically, in anesthetized swine, increased blood acidity (acidemia) and lack of effective respiration were found to be common during or immediately after CEW exposure. The acidemia could have been due to both metabolic and respiratory acidosis. A relatively rapid recovery toward baseline pH levels occurred. The lack of effective respiration has not been verified in experiments of CEW applications to human subjects; however, in some incidents of human deaths after CEW exposures subjects have been reported to stop breathing immediately after the exposure. It is not known if all human subjects exposed to CEW applications in the field (often "on drugs" or "in excited delirium") would be able to maintain adequate breathing. Since a limited number of short CEW applications would be less likely to cause adverse effects, however, CEWs can still be a valuable tool for law enforcement activities.

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The hemodynamic and arterial blood gas response to asphyxiation: a canine model of pulseless electrical activity

Cited by 45 publications

References 19 publications

Asphyxial cardiac arrest, resuscitation and neurological outcome in a Landrace/Large-White swine model

Asphyxial cardiac arrest, resuscitation and neurological outcome in a Landrace/Large-White swine model

Intraarrest Rhythms and Rhythm Conversion in Asphyxial Cardiac Arrest

Repeated or long-duration TASER® electronic control device exposures: acidemia and lack of respiration

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