Post-resuscitation myocardial microcirculatory dysfunction is ameliorated with eptifibatide
| Autor: | Taro Sasaoka, Robert A. Berg, Mathias Zuercher, Karl B. Kern, Haruhiko Higashi, Ronald W. Hilwig |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Resuscitation Swine Myocardial Ischemia Eptifibatide Platelet Glycoprotein GPIIb-IIIa Complex Emergency Nursing Placebo Microcirculation Coronary Circulation Intensive care medicine Animals Platelet Receptor business.industry Coronary flow reserve Cardiopulmonary Resuscitation Heart Arrest Disease Models Animal Anesthesia Emergency Medicine Female Peptides Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | Resuscitation. 82:85-89 |
| ISSN: | 0300-9572 |
| Popis: | Background The post-cardiac arrest syndrome includes a decline in myocardial microcirculation function. Inhibition of the platelet IIb/IIIa glycoprotein receptor has improved myocardial microvascular function post-percutaneous coronary intervention. Therefore, we evaluated such inhibition with eptifibatide for its effect on myocardial microcirculation function post-cardiac arrest and resuscitation. Methods Four groups of swine were studied in a prospective, randomized, blinded, placebo-controlled protocol including; eptifibatide administered during CPR (Group 1, n = 5), after resuscitation (Group 2, n = 4), during and after resuscitation (Group 3, n = 5), or placebo (Group 4, n = 10). CPR was initiated following 12 min of untreated VF. Those successfully resuscitated were studied during a 4-h post-resuscitation period. Coronary flow reserve, a measure of microcirculation function (in the absence of coronary obstruction), as well as parameters of left ventricular systolic and diastolic function, were measured pre-arrest and serially post-resuscitation. Results Coronary flow reserve was preserved during the post-resuscitation period, indicating normal microcirculatory function in the eptifibatide-treated animals, but not in the placebo-treated group. However, LV function declined equally in both groups during the first 4 h after cardiac arrest. Conclusion Inhibition of platelet IIb/IIIa glycoprotein receptors with eptifibatide post-resuscitation prevented myocardial microcirculation dysfunction. Left ventricular dysfunction post-resuscitation was not improved with eptifibatide, and perhaps transiently worse at 30 min post-resuscitation. Post-cardiac arrest ventricular dysfunction may require a multi-modality treatment strategy for successful prevention or amelioration. |
| Databáze: | OpenAIRE |
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