Pediatric Extracorporeal Cardiopulmonary Resuscitation: Development of a Porcine Model and the Influence of Cardiopulmonary Resuscitation Duration on Brain Injury.
cardiac arrest
cardiopulmonary resuscitation
extracorporeal membrane oxygenation
mitochondria
pediatric
Journal
Journal of the American Heart Association
ISSN: 2047-9980
Titre abrégé: J Am Heart Assoc
Pays: England
ID NLM: 101580524
Informations de publication
Date de publication:
21 02 2023
21 02 2023
Historique:
pubmed:
16
2
2023
medline:
25
2
2023
entrez:
15
2
2023
Statut:
ppublish
Résumé
Background The primary objective was to develop a porcine model of prolonged (30 or 60 minutes) pediatric cardiopulmonary resuscitation (CPR) followed by 22- to 24-hour survival with extracorporeal life support, and secondarily to evaluate differences in neurologic injury. Methods and Results Ten-kilogram, 4-week-old female piglets were used. First, model development established the technique (n=8). Then, a pilot study was conducted (n=15). After 80% survival was achieved in the final 5 pilot animals, a proof-of-concept randomized study was completed (n=11). Shams (n=6) underwent anesthesia only. Severe neurological injury was determined by a composite score of mitochondrial function, neuropathology, and cerebral metabolism: scale of 0-6 (severe: >3). Among 15 piglets in the pilot study, overall survival was 10 (67%); of the final 5, overall survival was 4 (80%). Eleven piglets were then randomized to 60 (CPR60, n=5) or 30 minutes of CPR (CPR30, n=5); 1 animal was excluded from prerandomization for intra-abdominal hemorrhage (10/11, 91% survival). Three of 5 animals in the CPR60 group had severe neurological injury scores versus 1 of 5 in the CPR30 group (
Identifiants
pubmed: 36789866
doi: 10.1161/JAHA.122.026479
pmc: PMC10111482
doi:
Types de publication
Randomized Controlled Trial
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e026479Subventions
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
Organisme : NHLBI NIH HHS
ID : K23 HL148541
Pays : United States
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