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

Research output: Contribution to journalArticle

5 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 languageEnglish (US)
Pages (from-to)244-253
Number of pages10
JournalJACC: Basic to Translational Science
Volume2
Issue number3
DOIs
StatePublished - Jun 2017

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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    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