Sodium nitroprusside enhanced cardiopulmonary resuscitation prevents post-resuscitation left ventricular dysfunction and improves 24-hour survival and neurological function in a porcine model of prolonged untreated ventricular fibrillation

Jason Schultz; Nicolas Segal; James Kolbeck; Emily Caldwell; Marit Thorsgard; Scott McKnite; Tom P. Aufderheide; Keith G. Lurie; Demetris Yannopoulos

doi:10.1016/S0300-9572(11)70149-6

Sodium nitroprusside enhanced cardiopulmonary resuscitation prevents post-resuscitation left ventricular dysfunction and improves 24-hour survival and neurological function in a porcine model of prolonged untreated ventricular fibrillation

Jason Schultz, Nicolas Segal, James Kolbeck, Emily Caldwell, Marit Thorsgard, Scott McKnite, Tom P. Aufderheide, Keith G. Lurie, Demetris Yannopoulos

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

13 Scopus citations

Abstract

Aim of study: Sodium nitroprusside-enhanced CPR, or SNPeCPR, consists of active compression-decompression CPR with an impedance threshold device, abdominal compression, and intravenous sodium nitroprusside (SNP). We hypothesize that SNPeCPR will improve post resuscitation left ventricular function and neurological function compared to standard (S) CPR after 15 min of untreated ventricular fibrillation in a porcine model of cardiac arrest. Methods: Pigs (n = 22) anesthetized with isoflurane underwent 15 min of untreated ventricular fibrillation, were then randomized to 6 min of S-CPR (n = 11) or SNPeCPR (n = 11) followed by defibrillation. The primary endpoints were neurologic function as measured by cerebral performance category (CPC) score and left ventricular ejection fraction. Results: SNPeCPR increased 24-hour survival rates compared to S-CPR (10/11 versus 5/11, p = 0.03) and improved neurological function (CPC score 2.5 ± 1, versus 3.8 ± 0.4, respectively, p = 0.004). Left ventricular ejection fractions at 1, 4 and 24 hours after defibrillation were 72 ± 11, 57 ± 11.4 and 64 ± 11 with SNPeCPR versus 29 ± 10, 30 ± 17 and 39 ± 6 with S-CPR, respectively (p < 0.01 for all). Conclusions: In this pig model, after 15 min of untreated ventricular fibrillation, SNPeCPR significantly improved 24-hour survival rates, neurologic function and prevented post-resuscitation left ventricular dysfunction compared to S-CPR.

Original language	English (US)
Pages (from-to)	S35-S40
Journal	Resuscitation
Volume	82
Issue number	SUPPL. 2
DOIs	https://doi.org/10.1016/S0300-9572(11)70149-6
State	Published - Dec 2011

Bibliographical note

Funding Information:
Tom P. Aufderheide, MD, has board membership for Take Heart America and Citizen CPR Foundation, has consulted for JoLife Medical and Medtronic Foundation, and has received grants/ grants pending from the NHLBI Immediate Trial, NHLBI Resuscitation Outcomes Consortium, NINDS Neurological Emergency Treatment Trials Network, and NHLBI Medical College of Wisconsin K12 Research Career Development.

Funding Information:
Demetris Yannopoulos, MD, is the Medical Director of the Minnesota Resuscitation Consortium, a state wide initiative to improve survival in the state of MN from cardiac arrest. This initiative is sponsored by the Medtronic Foundation and is part of the HeartRescue Program. There are no conflicts related to this investigation.

Funding Information:
The study was funded by an Institutional, Division of Cardiology grant at the University of Minnesota and R01 HL108926-01 NIH grant to Dr. Yannopoulos.

Keywords

Cardiopulmonary resuscitation
Left ventricular function
Neurological function
Survival
Vasodilation

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Schultz, J., Segal, N., Kolbeck, J., Caldwell, E., Thorsgard, M., McKnite, S., Aufderheide, T. P., Lurie, K. G., & Yannopoulos, D. (2011). Sodium nitroprusside enhanced cardiopulmonary resuscitation prevents post-resuscitation left ventricular dysfunction and improves 24-hour survival and neurological function in a porcine model of prolonged untreated ventricular fibrillation. Resuscitation, 82(SUPPL. 2), S35-S40. https://doi.org/10.1016/S0300-9572(11)70149-6

Sodium nitroprusside enhanced cardiopulmonary resuscitation prevents post-resuscitation left ventricular dysfunction and improves 24-hour survival and neurological function in a porcine model of prolonged untreated ventricular fibrillation. / Schultz, Jason; Segal, Nicolas; Kolbeck, James et al.

In: Resuscitation, Vol. 82, No. SUPPL. 2, 12.2011, p. S35-S40.

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

Schultz, J, Segal, N, Kolbeck, J, Caldwell, E, Thorsgard, M, McKnite, S, Aufderheide, TP, Lurie, KG & Yannopoulos, D 2011, 'Sodium nitroprusside enhanced cardiopulmonary resuscitation prevents post-resuscitation left ventricular dysfunction and improves 24-hour survival and neurological function in a porcine model of prolonged untreated ventricular fibrillation', Resuscitation, vol. 82, no. SUPPL. 2, pp. S35-S40. https://doi.org/10.1016/S0300-9572(11)70149-6

Schultz J, Segal N, Kolbeck J, Caldwell E, Thorsgard M, McKnite S et al. Sodium nitroprusside enhanced cardiopulmonary resuscitation prevents post-resuscitation left ventricular dysfunction and improves 24-hour survival and neurological function in a porcine model of prolonged untreated ventricular fibrillation. Resuscitation. 2011 Dec;82(SUPPL. 2):S35-S40. doi: 10.1016/S0300-9572(11)70149-6

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title = "Sodium nitroprusside enhanced cardiopulmonary resuscitation prevents post-resuscitation left ventricular dysfunction and improves 24-hour survival and neurological function in a porcine model of prolonged untreated ventricular fibrillation",

abstract = "Aim of study: Sodium nitroprusside-enhanced CPR, or SNPeCPR, consists of active compression-decompression CPR with an impedance threshold device, abdominal compression, and intravenous sodium nitroprusside (SNP). We hypothesize that SNPeCPR will improve post resuscitation left ventricular function and neurological function compared to standard (S) CPR after 15 min of untreated ventricular fibrillation in a porcine model of cardiac arrest. Methods: Pigs (n = 22) anesthetized with isoflurane underwent 15 min of untreated ventricular fibrillation, were then randomized to 6 min of S-CPR (n = 11) or SNPeCPR (n = 11) followed by defibrillation. The primary endpoints were neurologic function as measured by cerebral performance category (CPC) score and left ventricular ejection fraction. Results: SNPeCPR increased 24-hour survival rates compared to S-CPR (10/11 versus 5/11, p = 0.03) and improved neurological function (CPC score 2.5 ± 1, versus 3.8 ± 0.4, respectively, p = 0.004). Left ventricular ejection fractions at 1, 4 and 24 hours after defibrillation were 72 ± 11, 57 ± 11.4 and 64 ± 11 with SNPeCPR versus 29 ± 10, 30 ± 17 and 39 ± 6 with S-CPR, respectively (p < 0.01 for all). Conclusions: In this pig model, after 15 min of untreated ventricular fibrillation, SNPeCPR significantly improved 24-hour survival rates, neurologic function and prevented post-resuscitation left ventricular dysfunction compared to S-CPR.",

keywords = "Cardiopulmonary resuscitation, Left ventricular function, Neurological function, Survival, Vasodilation",

author = "Jason Schultz and Nicolas Segal and James Kolbeck and Emily Caldwell and Marit Thorsgard and Scott McKnite and Aufderheide, {Tom P.} and Lurie, {Keith G.} and Demetris Yannopoulos",

note = "Funding Information: Tom P. Aufderheide, MD, has board membership for Take Heart America and Citizen CPR Foundation, has consulted for JoLife Medical and Medtronic Foundation, and has received grants/ grants pending from the NHLBI Immediate Trial, NHLBI Resuscitation Outcomes Consortium, NINDS Neurological Emergency Treatment Trials Network, and NHLBI Medical College of Wisconsin K12 Research Career Development. Funding Information: Demetris Yannopoulos, MD, is the Medical Director of the Minnesota Resuscitation Consortium, a state wide initiative to improve survival in the state of MN from cardiac arrest. This initiative is sponsored by the Medtronic Foundation and is part of the HeartRescue Program. There are no conflicts related to this investigation. Funding Information: The study was funded by an Institutional, Division of Cardiology grant at the University of Minnesota and R01 HL108926-01 NIH grant to Dr. Yannopoulos.",

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doi = "10.1016/S0300-9572(11)70149-6",

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T1 - Sodium nitroprusside enhanced cardiopulmonary resuscitation prevents post-resuscitation left ventricular dysfunction and improves 24-hour survival and neurological function in a porcine model of prolonged untreated ventricular fibrillation

AU - Schultz, Jason

AU - Segal, Nicolas

AU - Kolbeck, James

AU - Caldwell, Emily

AU - Thorsgard, Marit

AU - McKnite, Scott

AU - Aufderheide, Tom P.

AU - Lurie, Keith G.

AU - Yannopoulos, Demetris

N1 - Funding Information: Tom P. Aufderheide, MD, has board membership for Take Heart America and Citizen CPR Foundation, has consulted for JoLife Medical and Medtronic Foundation, and has received grants/ grants pending from the NHLBI Immediate Trial, NHLBI Resuscitation Outcomes Consortium, NINDS Neurological Emergency Treatment Trials Network, and NHLBI Medical College of Wisconsin K12 Research Career Development. Funding Information: Demetris Yannopoulos, MD, is the Medical Director of the Minnesota Resuscitation Consortium, a state wide initiative to improve survival in the state of MN from cardiac arrest. This initiative is sponsored by the Medtronic Foundation and is part of the HeartRescue Program. There are no conflicts related to this investigation. Funding Information: The study was funded by an Institutional, Division of Cardiology grant at the University of Minnesota and R01 HL108926-01 NIH grant to Dr. Yannopoulos.

PY - 2011/12

Y1 - 2011/12

N2 - Aim of study: Sodium nitroprusside-enhanced CPR, or SNPeCPR, consists of active compression-decompression CPR with an impedance threshold device, abdominal compression, and intravenous sodium nitroprusside (SNP). We hypothesize that SNPeCPR will improve post resuscitation left ventricular function and neurological function compared to standard (S) CPR after 15 min of untreated ventricular fibrillation in a porcine model of cardiac arrest. Methods: Pigs (n = 22) anesthetized with isoflurane underwent 15 min of untreated ventricular fibrillation, were then randomized to 6 min of S-CPR (n = 11) or SNPeCPR (n = 11) followed by defibrillation. The primary endpoints were neurologic function as measured by cerebral performance category (CPC) score and left ventricular ejection fraction. Results: SNPeCPR increased 24-hour survival rates compared to S-CPR (10/11 versus 5/11, p = 0.03) and improved neurological function (CPC score 2.5 ± 1, versus 3.8 ± 0.4, respectively, p = 0.004). Left ventricular ejection fractions at 1, 4 and 24 hours after defibrillation were 72 ± 11, 57 ± 11.4 and 64 ± 11 with SNPeCPR versus 29 ± 10, 30 ± 17 and 39 ± 6 with S-CPR, respectively (p < 0.01 for all). Conclusions: In this pig model, after 15 min of untreated ventricular fibrillation, SNPeCPR significantly improved 24-hour survival rates, neurologic function and prevented post-resuscitation left ventricular dysfunction compared to S-CPR.

AB - Aim of study: Sodium nitroprusside-enhanced CPR, or SNPeCPR, consists of active compression-decompression CPR with an impedance threshold device, abdominal compression, and intravenous sodium nitroprusside (SNP). We hypothesize that SNPeCPR will improve post resuscitation left ventricular function and neurological function compared to standard (S) CPR after 15 min of untreated ventricular fibrillation in a porcine model of cardiac arrest. Methods: Pigs (n = 22) anesthetized with isoflurane underwent 15 min of untreated ventricular fibrillation, were then randomized to 6 min of S-CPR (n = 11) or SNPeCPR (n = 11) followed by defibrillation. The primary endpoints were neurologic function as measured by cerebral performance category (CPC) score and left ventricular ejection fraction. Results: SNPeCPR increased 24-hour survival rates compared to S-CPR (10/11 versus 5/11, p = 0.03) and improved neurological function (CPC score 2.5 ± 1, versus 3.8 ± 0.4, respectively, p = 0.004). Left ventricular ejection fractions at 1, 4 and 24 hours after defibrillation were 72 ± 11, 57 ± 11.4 and 64 ± 11 with SNPeCPR versus 29 ± 10, 30 ± 17 and 39 ± 6 with S-CPR, respectively (p < 0.01 for all). Conclusions: In this pig model, after 15 min of untreated ventricular fibrillation, SNPeCPR significantly improved 24-hour survival rates, neurologic function and prevented post-resuscitation left ventricular dysfunction compared to S-CPR.

KW - Cardiopulmonary resuscitation

KW - Left ventricular function

KW - Neurological function

KW - Survival

KW - Vasodilation

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Sodium nitroprusside enhanced cardiopulmonary resuscitation prevents post-resuscitation left ventricular dysfunction and improves 24-hour survival and neurological function in a porcine model of prolonged untreated ventricular fibrillation

Abstract

Bibliographical note

Keywords

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