Inhaled nitric oxide improves transpulmonary blood flow and clinical outcomes after prolonged cardiac arrest: a large animal study

摘要: The probability to achieve a return of spontaneous circulation (ROSC) after cardiac arrest can be improved by optimizing during cardiopulomonary resuscitation using percutaneous left ventricular assist device (iCPR). Inhaled nitric oxide may facilitate transpulmonary blood flow iCPR and therefore improve organ perfusion outcome. Ventricular fibrillation was electrically induced in 20 anesthetized male pigs. Animals were untreated for 10 minutes before attempted. Subjects received either ppm inhaled (iNO, n = 10) or 0 iNO (Control, 10), simultaneously started with until 5 hours following ROSC. weaned from the respirator followed up five days overall performance categories (OPC) spatial memory task. On day six, all animals again, brains harvested neurohistopathologic evaluation. All both groups achieved Administration markedly increased CPR (iNO: 1.81 ± 0.30 vs Control: 1.64 0.51 L/min, p < 0.001), leading significantly higher coronary pressure (CPP) 6 (25 13 16 mmHg, 0.002). iNO-treated showed lower S-100 serum levels thirty post ROSC (0.26 0.09 0.38 0.15 ng/mL, 0.048), as well glucose 120–360 Lower reflected superior clinical outcome estimated OPC (3 2 vs. 1, 0.036 on 3 5). Three out ten iNO-treated, but none Control able successfully participate Neurohistopathological examination vulnerable cerebral structures revealed trend towards less lesions neocortex, archicortex, striatum compared Controls. In pigs resuscitated mechanically-assisted prolonged arrest, administration flow, neurological outcomes.