Percutaneous left ventricular assist device can prevent acute cerebral ischaemia during ventricular fibrillation
| Autor: | Ketil Grong, Vegard Tuseth, Reidar J. Pettersen, Tore Wentzel-Larsen, Jan Erik Nordrehaug, Mikael Farstad, Paul Husby, Svein Rotevatn, A. Epstein |
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| Rok vydání: | 2009 |
| Předmět: |
Cardiac Catheterization
medicine.medical_specialty Microdialysis Swine medicine.medical_treatment Ischemia Emergency Nursing Brain Ischemia Brain ischemia Hemoglobins Left coronary artery Internal medicine medicine.artery Intensive care Animals Medicine Lactic Acid Cardiac catheterization business.industry Hemodynamics medicine.disease Microspheres Heart Arrest Cerebrovascular Circulation Anesthesia Ventricular assist device Acute Disease Ventricular Fibrillation Ventricular fibrillation Emergency Medicine Cardiology Vascular Resistance Heart-Assist Devices Cardiology and Cardiovascular Medicine business Blood Flow Velocity |
| Zdroj: | Resuscitation. 80:1197-1203 |
| ISSN: | 0300-9572 |
| Popis: | A percutaneous left ventricular assist device has been shown to be able to perfuse cardiac and cerebral tissues during cardiac arrest and may be a useful supplement to current methods in resuscitation. We wished to assess device-assisted circulation during cardiac arrest with microspheres injections and continuous end-tidal CO(2) monitoring, and used cerebral microdialysis to detect ischaemia in the brain.12 anaesthetised pigs had microdialysis and pressure catheters implanted via craniotomy. The percutaneous assist device was deployed transfemorally. Ventricular fibrillation was induced by angioplasty-balloon occlusion of the left coronary artery. Cerebral microdialysis samples representing 0-20 and 20-40 min of cardiac arrest with assisted circulation were analysed for markers of cerebral injury (glucose, pyruvate, lactate, and glycerol).Microdialysis showed no ischaemic changes after 20 min of cardiac arrest (P=NS to Baseline for glucose, glycerol, lactate, pyruvate and lactate/pyruvate ratio) in subjects with maintained end-tidal CO(2) values above 1.3 kPa (10 mmHg). After 40 min only lactate showed a significant change compared to Baseline (P0.05). Microspheres flow to the brain was 57% and myocardial flow was 72% compared to Baseline after 15 min (P0.05). After 45 min flow declined to 22% and 40% of Baseline, respectively (P=NS vs. 15 min).A percutaneous left ventricular assist device may prevent ischaemic cerebral injury during cardiac arrest for a limited time. Cerebral injury and tissue perfusion were indicated by end-tidal CO(2). |
| Databáze: | OpenAIRE |
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