Pulsatile reperfusion after cardiac arrest improves neurologic outcome.

Published

Journal Article

Cardiopulmonary bypass (CPB) using nonpulsatile flow (NPF) is advocated for refractory cardiac arrest. This study examined cerebral outcome after resuscitation with pulsatile flow (PF) versus NPF. Dogs arrested for 12.5 minute were reperfused with NPF (n = 11) using roller pump CPB or PF (n = 11) using mechanical biventricular cardiac massage. Pump flows were similar between groups; however early arterial pressures were greater during PF versus NPF, *p less than 0.05. Circulatory support was weaned at 60 minutes' reperfusion. Neurologic recovery of survivors (n = 16) was significantly better after PF versus NPF, *p = 0.01. The presence of brain lesions on magnetic resonance images did not significantly differ between groups at 7 days. Brain then were removed and regions examined for ischemic changes. Loss of CA1 pyramidal neurons was more severe after NPF versus PF, +p = 0.009. Ischemic changes were more frequent after NPF in the caudate nucleus (+p = 0.009) and watershed regions of the cerebral cortex (+p = 0.062), compared with PF. These results demonstrate that PF improves cerebral resuscitation when treating cardiac arrest with mechanical circulatory support (* = MANOVA with repeated measures, + = categorical data analysis.

Full Text

Cited Authors

  • Anstadt, MP; Stonnington, MJ; Tedder, M; Crain, BJ; Brothers, MF; Hilleren, DJ; Rahija, RJ; Menius, JA; Lowe, JE

Published Date

  • October 1991

Published In

Volume / Issue

  • 214 / 4

Start / End Page

  • 478 - 488

PubMed ID

  • 1953100

Pubmed Central ID

  • 1953100

Electronic International Standard Serial Number (EISSN)

  • 1528-1140

International Standard Serial Number (ISSN)

  • 0003-4932

Digital Object Identifier (DOI)

  • 10.1097/00000658-199110000-00012

Language

  • eng