BODY POSITION DURING TRANSPORT AND IMMEDIATE INTRANASAL EVAPORATIVE COOLING EFFECTIVENESS ASSESSMENT IN REFRACTORY CARDIAC ARREST PORCINE MODEL | XXIII. výroční sjezd České kardiologické společnosti

Background: Cardiac arrest patients are not transported only supine. Effect of body position on resuscitability and cerebral perfusion in 30° and 60° incline is not known.
Methods: 25 female pigs were subjected to a simulated cardiac arrest (3 min no-flow, 5 min mechanical CPR). Next, animals were randomly assigned to one of the three groups: GROUP 60 (n=8), i.e. 60° incline for 3 minutes to simulate transport in space restricted elevator; GROUP 30 (n=8), 30° incline for 8 minutes to simulate staircase transport; and GROUP 0 with no incline. During subsequent standard CPR including rescue ECMO, resuscitability and cerebral perfusion were assessed.
Results: Attainment of ROSC (3, 5, 5 in respective groups, p=0.021), time to ROSC [15:24 (13:26;16:02) vs 19:19 (18:28;19:37) vs 9:10 min (8:28;9:41), resp., p=0.005] significantly differed. Changes in carotid blood flow according to respective periods of the protocol (baseline, cardiac arrest, initial supine CPR and 30°vs. 60° CPR) are depicted in figure.
Conclusion: Positional changes during simulated refractory cardiac arrest in this experimental model significantly affect resuscitability and brain perfusion. Animals subjected to shorter time in a more inclined (GROUP 60) position were more easily resuscitated, however, cerebral blood flow was better preserved in GROUP 30.
Key words: cardiac arrest, mechanical CPR, intraarrest, intranasal evaporative cooling, brain oxygenation, brain perfusion

BODY POSITION DURING TRANSPORT AND IMMEDIATE INTRANASAL EVAPORATIVE COOLING EFFECTIVENESS ASSESSMENT IN REFRACTORY CARDIAC ARREST PORCINE MODEL Tématický okruh: Akutní stavy v kardiologii, Akutní koronární syndromy
Typ: Ústní sdělení - lékařské , Číslo v programu: 205


Bělohlávek J. ¹, Mlček M. ², Huptych M. ³, Bouček T. ⁴, Belza T. ⁵, Krupičková P. ⁶, Ošťádal P. ⁷, Neužil P. ⁸, Linhart A. ⁹, Kittnar O. ¹⁰ ¹ II. Interní klinika, VFN Praha, Praha, ² Fyziologický ústav 1LF, Univerzita Karlova, Praha, ³ BioDat Research Group, Oddělení kybernetiky, FEL, ČVUT, ⁴ II. interní klinika, Všeobecná fakultní nemocnice v Praze, Praha, ⁵ Kardiologie, Kardiologie-Liberec s.r.o., Liberec, ⁶ 1. lékářská fakulta, Univerzita Karlova v Praze, Praha, ⁷ Kardiologická klinika, Fakultní nemocnice v Motole, Praha, ⁸ Kardiologické oddělení, Nemocnice na Homolce, Praha, ⁹ II. interní klinika, VFN Praha, Praha, ¹⁰ Fyziologický ústav, 1LF UK Praha, Praha
Background: Cardiac arrest patients are not transported only supine. Effect of body position on resuscitability and cerebral perfusion in 30° and 60° incline is not known. Methods: 25 female pigs were subjected to a simulated cardiac arrest (3 min no-flow, 5 min mechanical CPR). Next, animals were randomly assigned to one of the three groups: GROUP 60 (n=8), i.e. 60° incline for 3 minutes to simulate transport in space restricted elevator; GROUP 30 (n=8), 30° incline for 8 minutes to simulate staircase transport; and GROUP 0 with no incline. During subsequent standard CPR including rescue ECMO, resuscitability and cerebral perfusion were assessed. Results: Attainment of ROSC (3, 5, 5 in respective groups, p=0.021), time to ROSC [15:24 (13:26;16:02) vs 19:19 (18:28;19:37) vs 9:10 min (8:28;9:41), resp., p=0.005] significantly differed. Changes in carotid blood flow according to respective periods of the protocol (baseline, cardiac arrest, initial supine CPR and 30°vs. 60° CPR) are depicted in figure. Conclusion: Positional changes during simulated refractory cardiac arrest in this experimental model significantly affect resuscitability and brain perfusion. Animals subjected to shorter time in a more inclined (GROUP 60) position were more easily resuscitated, however, cerebral blood flow was better preserved in GROUP 30. Key words: cardiac arrest, mechanical CPR, intraarrest, intranasal evaporative cooling, brain oxygenation, brain perfusion

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