Myocardial acidosis associated with CO2 production during cardiac arrest and resuscitation

Circulation
M von PlantaE C Rackow

Abstract

Previous studies from our institution demonstrated significant hypercarbic acidosis in the mixed venous (pulmonary artery) blood in animals and human patients during cardiac arrest and cardiopulmonary resuscitation (CPR). In the present study, the acid-base state of the myocardium during cardiac arrest was investigated. Cardiac arrest was electrically induced in 11 pentobarbital-anesthetized and mechanically ventilated domestic pigs. Precordial compression was begun 3 minutes after onset of ventricular fibrillation and continued for 8 minutes. During CPR, there was rapid onset of profound myocardial acidosis with an increase in intramyocardial [H+] from 54 +/- 5 to 146 +/- 20 nmol/l (7.27 +/- 0.04 to 6.88 +/- 0.20 pH units). Great cardiac vein PCO2 increased from 57 +/- 2 to 158 +/- 12 mm Hg. Profound hypercarbic acidosis in great cardiac vein blood was associated with myocardial lactate production to levels of 8.1 +/- 0.7 mmol/l. Only moderate decreases in cardiac vein bicarbonate concentrations from 31 +/- 1 to 23 +/- 1 mmol/l were observed. These acid-base changes were almost completely reversed over an interval of 60 minutes after the animals were successfully resuscitated by DC countershock. The PCO2 in cardiac vein blood ...Continue Reading

References

Nov 1, 1975·The American Journal of Physiology·P A Poole-Wilson, I R Cameron
Sep 1, 1975·The American Journal of Physiology·P A Poole-Wilson, G A Langer
Oct 1, 1976·Respiration Physiology·J A BetticeE B Brown
Nov 1, 1976·The Journal of Physiology·D Ellis, R C Thomas
Nov 1, 1977·Journal of Molecular and Cellular Cardiology·W Gevers
Jun 1, 1976·Acta Physiologica Scandinavica·R G Samuelsson, G Nagy
Jul 1, 1988·Journal of Clinical Pharmacology·M von PlantaE C Rackow
Jul 17, 1986·The New England Journal of Medicine·M H WeilM I Griffel
May 1, 1987·Annals of Emergency Medicine·R M NowakM C Tomlanovich
Mar 10, 1988·The New England Journal of Medicine·J L FalkM H Weil
Dec 1, 1988·Journal of Applied Physiology·I von PlantaE C Rackow
Nov 1, 1985·Critical Care Medicine·M H WeilE C Rackow
Nov 1, 1973·Respiration Physiology·Y L LaiE B Brown
Mar 1, 1970·Circulation Research·H E CingolaniN C Gonzalez
Jan 1, 1967·Cardiologia : bollettino della Società italiana di cardiologia·W SchaperR Xhonneux
Dec 11, 1966·The American Journal of Physiology·R L Clancy, E B Brown
Apr 11, 1967·The American Journal of Physiology·R L ClancyJ P Gilmore
Mar 1, 1984·Pacing and Clinical Electrophysiology : PACE·T A Bowman, H C Hughes
Sep 1, 1984·Annals of Emergency Medicine·J W McGill, E Ruiz
Jul 1, 1981·American Journal of Clinical Pathology·M H WeilR W Carlson
Aug 1, 1980·Journal of Molecular and Cellular Cardiology·S M Cobbe, P A Poole-Wilson
Mar 1, 1957·Proceedings of the Society for Experimental Biology and Medicine·D B HOULEG S CAMPBELL
May 13, 1910·The Journal of Physiology·E Jerusalem, E H Starling

❮ Previous
Next ❯

Citations

Jun 30, 1990·Lancet
Jan 1, 1997·Biosensors & Bioelectronics·C G Cooney, B C Towe
Jul 1, 1997·Disease-a-month : DM·M H Weil, W Tang
Sep 5, 2012·Nature Reviews. Nephrology·Jeffrey A Kraut, Nicolaos E Madias
Mar 1, 1995·Critical Care Medicine·A Zaritsky
Mar 1, 1996·Critical Care Medicine·M H Weil, W Tang
Jun 1, 1996·Critical Care Medicine·R J GazmuriD McKee
Dec 1, 1996·Critical Care Medicine·S SunM Fukui
Jun 11, 1999·Critical Care Medicine·G Bjerneroth
Jun 2, 2000·Critical Care Medicine·R J Gazmuri, I M Ayoub
Feb 27, 2009·Critical Care Medicine·Giuseppe RistagnoMax Harry Weil
Jun 25, 1998·American Journal of Respiratory and Critical Care Medicine·Y NakagawaJ Bisera
Aug 1, 1993·The American Review of Respiratory Disease·D J CooperK R Walley
Oct 1, 1993·The American Review of Respiratory Disease·H Zhang, J L Vincent
Dec 1, 1990·The Journal of Clinical Investigation·M A Portman, X H Ning
Oct 1, 1993·Chest·V S DesaiJ Bisera
Mar 22, 2012·Critical Care Clinics·Raúl J Gazmuri, Jeejabai Radhakrishnan
Jan 25, 2011·Translational Research : the Journal of Laboratory and Clinical Medicine·Jeejabai RadhakrishnanRaúl J Gazmuri
Dec 17, 2015·Best Practice & Research. Clinical Anaesthesiology·Rinaldo BellomoGlenn Matthew Eastwood
Mar 1, 1996·The American Journal of Emergency Medicine·R B VukmirP Safar
Mar 1, 1993·Disease-a-month : DM·E BenjaminT J Iberti
Aug 1, 1990·Disease-a-month : DM·M H WeilE C Rackow
Jun 1, 1993·Journal of Cardiothoracic and Vascular Anesthesia·L Landow, M S Visner
Jan 1, 1994·Resuscitation·G TrillòF Kette
Mar 1, 1993·International Journal of Cardiology·I von PlantaR Ritz

❮ Previous
Next ❯

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