Role of Epinephrine and Extracorporeal Membrane Oxygenation in the Management of Ischemic Refractory Ventricular Fibrillation: A Randomized Trial in Pigs

Jason A. Bartos; Sebastian Voicu; Timothy R. Matsuura; Adamantios Tsangaris; Georgios Sideris; Brett A. Oestreich; Stephen A. George; Matthew Olson; Kadambari Chandra Shekar; Jennifer N. Rees; Kathleen Carlson; Pierre Sebastian; Scott McKnite; Ganesh Raveendran; Tom P. Aufderheide; Demetris Yannopoulos

doi:10.1016/j.jacbts.2017.02.003

Role of Epinephrine and Extracorporeal Membrane Oxygenation in the Management of Ischemic Refractory Ventricular Fibrillation: A Randomized Trial in Pigs

Jason A. Bartos, Sebastian Voicu, Timothy R. Matsuura, Adamantios Tsangaris, Georgios Sideris, Brett A. Oestreich, Stephen A. George, Matthew Olson, Kadambari Chandra Shekar, Jennifer N. Rees, Kathleen Carlson, Pierre Sebastian, Scott McKnite, Ganesh Raveendran, Tom P. Aufderheide, Demetris Yannopoulos

Medicine - Cardiology Division

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

Extracorporeal membrane oxygenation (ECMO) is used in cardiopulmonary resuscitation (CPR) of refractory cardiac arrest. The authors used a 2 × 2 study design to compare ECMO versus CPR and epinephrine versus placebo in a porcine model of ischemic refractory ventricular fibrillation (VF). Pigs underwent 5 min of untreated VF and 10 min of CPR, and were randomized to receive epinephrine versus placebo for another 35 min. Animals were further randomized to left anterior descending artery (LAD) reperfusion at minute 45 with ongoing CPR versus venoarterial ECMO cannulation at minute 45 of CPR and subsequent LAD reperfusion. Four-hour survival was improved with ECMO whereas epinephrine showed no effect.

Original language	English (US)
Pages (from-to)	244-253
Number of pages	10
Journal	JACC: Basic to Translational Science
Volume	2
Issue number	3
DOIs	https://doi.org/10.1016/j.jacbts.2017.02.003
State	Published - Jun 2017

Bibliographical note

Funding Information:
This study was funded by a grant (R01HL108926) to Dr. Yannopoulos from the National Institutes of Health National Heart, Lung, and Blood Institute. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Bartos and Voicu contributed equally to this work.

Publisher Copyright:
© 2017 The Authors

Keywords

ECMO
ST-segment elevation myocardial infarction
advanced cardiopulmonary life support
cardiac arrest
cardiopulmonary resuscitation
extracorporeal membrane oxygenation
ischemic refractory ventricular fibrillation
ventricular fibrillation

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10.1016/j.jacbts.2017.02.003

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693223

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Bartos, J. A., Voicu, S., Matsuura, T. R., Tsangaris, A., Sideris, G., Oestreich, B. A., George, S. A., Olson, M., Shekar, K. C., Rees, J. N., Carlson, K., Sebastian, P., McKnite, S., Raveendran, G., Aufderheide, T. P., & Yannopoulos, D. (2017). Role of Epinephrine and Extracorporeal Membrane Oxygenation in the Management of Ischemic Refractory Ventricular Fibrillation: A Randomized Trial in Pigs. JACC: Basic to Translational Science, 2(3), 244-253. https://doi.org/10.1016/j.jacbts.2017.02.003

Bartos, JA, Voicu, S, Matsuura, TR, Tsangaris, A, Sideris, G, Oestreich, BA, George, SA, Olson, M, Shekar, KC, Rees, JN, Carlson, K, Sebastian, P, McKnite, S, Raveendran, G, Aufderheide, TP & Yannopoulos, D 2017, 'Role of Epinephrine and Extracorporeal Membrane Oxygenation in the Management of Ischemic Refractory Ventricular Fibrillation: A Randomized Trial in Pigs', JACC: Basic to Translational Science, vol. 2, no. 3, pp. 244-253. https://doi.org/10.1016/j.jacbts.2017.02.003

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abstract = "Extracorporeal membrane oxygenation (ECMO) is used in cardiopulmonary resuscitation (CPR) of refractory cardiac arrest. The authors used a 2 × 2 study design to compare ECMO versus CPR and epinephrine versus placebo in a porcine model of ischemic refractory ventricular fibrillation (VF). Pigs underwent 5 min of untreated VF and 10 min of CPR, and were randomized to receive epinephrine versus placebo for another 35 min. Animals were further randomized to left anterior descending artery (LAD) reperfusion at minute 45 with ongoing CPR versus venoarterial ECMO cannulation at minute 45 of CPR and subsequent LAD reperfusion. Four-hour survival was improved with ECMO whereas epinephrine showed no effect.",

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AU - McKnite, Scott

AU - Raveendran, Ganesh

AU - Aufderheide, Tom P.

AU - Yannopoulos, Demetris

N1 - Funding Information: This study was funded by a grant (R01HL108926) to Dr. Yannopoulos from the National Institutes of Health National Heart, Lung, and Blood Institute. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Bartos and Voicu contributed equally to this work. Publisher Copyright: © 2017 The Authors

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Role of Epinephrine and Extracorporeal Membrane Oxygenation in the Management of Ischemic Refractory Ventricular Fibrillation: A Randomized Trial in Pigs

Abstract

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Keywords

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