Correlation of Impedance Threshold Device use during cardiopulmonary resuscitation with post-cardiac arrest Acute Kidney Injury
| Autor: | Vasileios Spapis, Theodoros Xanthos, Panagiota Niforopoulou, George Kaparos, Nicoletta Iacovidou, Αpostolos Papalois, Spyros I. Siakavellas, Pavlos Lelovas, Ioanna Siafaka, George Karlis |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Epinephrine Swine Defibrillation medicine.medical_treatment Hemodynamics 030204 cardiovascular system & hematology Return of spontaneous circulation 03 medical and health sciences 0302 clinical medicine Lipocalin-2 Electric Impedance medicine Animals Cardiopulmonary resuscitation Asystole Monitoring Physiologic business.industry Interleukin-18 Acute kidney injury 030208 emergency & critical care medicine General Medicine Acute Kidney Injury Impedance threshold device medicine.disease Cardiopulmonary Resuscitation Heart Arrest Surgery Disease Models Animal Anesthesia Ventricular Fibrillation Ventricular fibrillation Emergency Medicine Female business Biomarkers |
| Zdroj: | The American Journal of Emergency Medicine. 35:846-854 |
| ISSN: | 0735-6757 |
| DOI: | 10.1016/j.ajem.2017.01.040 |
| Popis: | Purpose To assess whether use of Impedance Threshold Device (ITD) during cardiopulmonary resuscitation (CPR) reduces the degree of post-cardiac arrest Acute Kidney Injury (AKI), as a result of improved hemodynamics, in a porcine model of ventricular fibrillation (VF) cardiac arrest. Methods After 8 min of untreated cardiac arrest, the animals were resuscitated either with active compression-decompression (ACD) CPR plus a sham ITD (control group, n =8) or with ACD-CPR plus an active ITD (ITD group, n =8). Adrenaline was administered every 4 min and electrical defibrillation was attempted every 2 min until return of spontaneous circulation (ROSC) or asystole. After ROSC the animals were monitored for 6 h under general anesthesia and then returned to their cages for a 48 h observation, before euthanasia. Two novel biomarkers, Neutrophil Gelatinase-Associated Lipocalin (NGAL) in plasma and Interleukin-18 (IL-18) in urine, were measured at 2 h, 4 h, 6 h, 24 h and 48 h post-ROSC, in order to assess the degree of AKI. Results ROSC was observed in 7 (87.5%) animals treated with the sham valve and 8 (100%) animals treated with the active valve ( P =NS). However, more than twice as many animals survived at 48 h in the ITD group ( n =8, 100%) compared to the control group ( n =3, 37.5%). Urine IL-18 and plasma NGAL levels were augmented post-ROSC in both groups, but they were significantly higher in the control group compared with the ITD group, at all measured time points. Conclusion Use of ITD during ACD-CPR improved hemodynamic parameters, increased 48 h survival and decreased the degree of post-cardiac arrest AKI in the resuscitated animals. |
| Databáze: | OpenAIRE |
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