Jan 5, 2002

Use of an inspiratory impedance valve improves neurologically intact survival in a porcine model of ventricular fibrillation

Circulation
Keith LurieWolfgang Voelckel

Abstract

This study evaluated the potential for an inspiratory impedance threshold valve (ITV) to improve 24-hour survival and neurological function in a pig model of cardiac arrest. Using a randomized, prospective, and blinded design, we compared the effects of a sham versus active ITV on 24-hour survival and neurological function. After 6 minutes of ventricular fibrillation (VF), followed by 6 minutes of cardiopulmonary resuscitation (CPR) with either a sham or an active valve, anesthetized pigs received 3 sequential 200-J shocks. If VF persisted, they received epinephrine (0.045 mg/kg), 90 seconds of CPR, and 3 more 200-J shocks. A total of 11 of 20 pigs (55%) in the sham versus 17 of 20 (85%) in the active valve group survived for 24 hours (P<0.05). Neurological scores were significantly higher with the active valve; the cerebral performance score (1=normal, 5=brain death) was 2.2+/-0.2 with the sham ITV versus 1.4+/-0.2 with the active valve (P<0.05). A total of 1 of 11 in the sham versus 12 of 17 in the active valve group had completely normal neurological function (P<0.05). Peak end-tidal CO2 (PETCO2) values were significantly higher with the active valve (20.4+/-1.0) than the sham (16.8+/-1.5) (P<0.05). PETCO2 >18 mm Hg correlat...Continue Reading

Mentioned in this Paper

Coronary Circulation
Ventricular Fibrillation
Dioxygen
Salicylhydroxamic acid
Electric Impedance
Systolic Blood Pressure Measurement
Brain
Basic Cardiac Life Support
Shock
Brain Death

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