porcine-cardiac-arrest-model-using-an-implantable-defibrillator

Porcine Cardiac Arrest Model Using an Implantable Defibrillator

This study presents a reproducible porcine cardiac arrest model utilizing an implantable cardioverter-defibrillator (ICD) for reliable induction and ...

Nord University

UiT The Arctic University of Norway

We assessed the hemodynamic effects of guideline therapy in experimental cardiogenic shock and compared this treatment with a combination containing an alternative vasopressor (arginine vasopressin, AVP). Our hypothesis was that combined dobutamine-norepinephrine still is the superior inopressor therapy assessed by ventriculoarterial matching in both systole and diastole. Cardiogenic shock (CS) was induced by coronary microembolization in 16 pigs. Dobutamine (Dobu, 2ug/kg/min) alone and combined with either norepinephrine (NE, 100 ng/kg/min) or the pure vasopressor AVP (0.001 u/kg/min) were infused. In CS, Dobu increased cardiac output (CO) and central venous oxygen saturation (SVO₂) from 74 ± 3 mL/kg and 37 ± 2% to 103 ± 8 mL/kg and 49 ± 3%. Adding NE resulted in a further improvement of CO (125 ± 9 mL/kg) and SVO₂ (59 ± 4%) because of an increased heart rate and contractility with minimal change in systemic vascular resistance. Also, energy transfer from the ventricle to the arterial system was restored partly by Dobu and was normalized by supplementing NE. In contrast, supplemental AVP further worsened the shock state by decreasing CO (70 ± 6 mL/kg) and SVO₂ (45 ± 5%) compared with Dobu alone. Combined Dobu-NE has an efficient hemodynamic profile in CS. A pure afterload increasing substance used in acute ischemic CS aggravates the shock state by causing a ventriculoarterial mismatch despite its use in combination with an inotropic compound.

Dobutamine-norepinephrine, but not vasopressin, restores the ventriculoarterial matching in experimental cardiogenic shock.

Omecamtiv mecarbil (OM) is a novel inotropic agent that prolongs systolic ejection time and increases ejection fraction through myosin ATPase activation. We hypothesized that a potentially favorable energetic effect of unloading the left ventricle, and thus reduction of wall stress, could be counteracted by the prolonged contraction time and ATP-consumption.

Myosin Activator Omecamtiv Mecarbil Increases Myocardial Oxygen Consumption and Impairs Cardiac Efficiency Mediated by Resting Myosin ATPase Activity.

Pulse palpation is an unreliable method for diagnosing cardiac arrest. To address this limitation, continuous hemodynamic monitoring may be a viable solution. Therefore, we developed a novel, hands-free Doppler system, RescueDoppler, to detect the pulse continuously in the carotid artery.

Hands-free continuous carotid Doppler ultrasound for detection of the pulse during cardiac arrest in a porcine model.

Identifying spontaneous circulation during cardiopulmonary resuscitation (CPR) is challenging. Current methods, which involve intermittent and time-consuming pulse checks, necessitate pauses in chest compressions. This issue is problematic in both in-hospital cardiac arrest and out-of-hospital cardiac arrest situations, where resources for identifying circulation during CPR may be limited. The fraction of chest compression plays a pivotal role in improving survival rates. To address this challenge, we evaluated a newly developed hands-free, continuous carotid Doppler system (RescueDoppler), designed to identify spontaneous circulation during chest compressions. In our study, we utilized a porcine model of cardiac arrest to investigate sequences of ventricular fibrillation, followed by defibrillation, and monitoring for the return of spontaneous circulation during chest compressions with the carotid Doppler system. We explored both manual compressions at 100 and 50 compressions per minute and mechanical compressions. To estimate the detection rate (i.e., sensitivity), we employed a logistic mixed model with animal identity as random effect.

Article	Year
Dobutamine-norepinephrine, but not vasopressin, restores the ventriculoarterial matching in experimental cardiogenic shock. Translational research : the journal of laboratory and clinical medicine\| PubMed ID: 20970750	2010
Myosin Activator Omecamtiv Mecarbil Increases Myocardial Oxygen Consumption and Impairs Cardiac Efficiency Mediated by Resting Myosin ATPase Activity. Circulation. Heart failure\| PubMed ID: 26025342	2015
Hands-free continuous carotid Doppler ultrasound for detection of the pulse during cardiac arrest in a porcine model. Resuscitation plus\| PubMed ID: 37448689	2023
A hands-free carotid Doppler can identify spontaneous circulation without interrupting cardiopulmonary resuscitation: an animal study. Intensive care medicine experimental\| PubMed ID: 39730782	2024

Ole-Jakob How

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