A randomized and blinded trial of inhaled nitric oxide in a piglet model of pediatric cardiopulmonary resuscitation.
Cardiopulmonary resuscitation
Cerebral blood flow
Hemodynamics
In-hospital cardiac arrest
Inhaled nitric oxide
Laboratory
Pediatrics
Physiology
Pulmonary hypertension
Shock
Journal
Resuscitation
ISSN: 1873-1570
Titre abrégé: Resuscitation
Pays: Ireland
ID NLM: 0332173
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
received:
13
11
2020
revised:
22
02
2021
accepted:
09
03
2021
pubmed:
27
3
2021
medline:
29
6
2021
entrez:
26
3
2021
Statut:
ppublish
Résumé
Inhaled nitric oxide (iNO) during cardiopulmonary resuscitation (CPR) improved systemic hemodynamics and outcomes in a preclinical model of adult in-hospital cardiac arrest (IHCA) and may also have a neuroprotective role following cardiac arrest. The primary objectives of this study were to determine if iNO during CPR would improve cerebral hemodynamics and mitochondrial function in a pediatric model of lipopolysaccharide-induced shock-associated IHCA. After lipopolysaccharide infusion and ventricular fibrillation induction, 20 1-month-old piglets received hemodynamic-directed CPR and were randomized to blinded treatment with or without iNO (80 ppm) during and after CPR. Defibrillation attempts began at 10 min with a 20-min maximum CPR duration. Cerebral tissue from animals surviving 1-h post-arrest underwent high-resolution respirometry to evaluate the mitochondrial electron transport system and immunohistochemical analyses to assess neuropathology. During CPR, the iNO group had higher mean aortic pressure (41.6 ± 2.0 vs. 36.0 ± 1.4 mmHg; p = 0.005); diastolic BP (32.4 ± 2.4 vs. 27.1 ± 1.7 mmHg; p = 0.03); cerebral perfusion pressure (25.0 ± 2.6 vs. 19.1 ± 1.8 mmHg; p = 0.02); and cerebral blood flow relative to baseline (rCBF: 243.2 ± 54.1 vs. 115.5 ± 37.2%; p = 0.02). Among the 8/10 survivors in each group, the iNO group had higher mitochondrial Complex I oxidative phosphorylation in the cerebral cortex (3.60 [3.56, 3.99] vs. 3.23 [2.44, 3.46] pmol O Treatment with iNO during CPR resulted in superior systemic hemodynamics, rCBF, and cerebral mitochondrial Complex I respiration in this pediatric cardiac arrest model.
Identifiants
pubmed: 33766668
pii: S0300-9572(21)00108-8
doi: 10.1016/j.resuscitation.2021.03.004
pmc: PMC8096708
mid: NIHMS1690865
pii:
doi:
Substances chimiques
Nitric Oxide
31C4KY9ESH
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
274-283Subventions
Organisme : NHLBI NIH HHS
ID : K23 HL148541
Pays : United States
Organisme : NINDS NIH HHS
ID : K23 NS109284
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL141386
Pays : United States
Organisme : NICHD NIH HHS
ID : R21 HD089132
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.
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