Journal
RESUSCITATION
Volume 81, Issue 1, Pages 106-110Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.resuscitation.2009.09.013
Keywords
Sodium-hydrogen antiporter; Cariporide; Ventricular fibrillation; Cardiac arrest; Cardiopulmonary resuscitation; Arrhythmia; Myocardial stunning; Ventricular dysfunction
Categories
Funding
- National Institutes of Health [R01 HL71728-01]
- VA Merit
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [R01HL071728] Funding Source: NIH RePORTER
Ask authors/readers for more resources
Episodes of ventricular fibrillation (VF) and myocardial dysfunction commonly occur after cardiac resuscitation compromising the return of stable circulation. We investigated in a pig model of VF whether limiting Na+-induced cytosolic Ca2+ overload using the sarcolemmal sodium-hydrogen exchanger isoform-1 (NHE-1) inhibitor cariporide promotes resuscitation with stable circulation. Methods: VF was electrically induced in 20 male pigs and left untreated for 6 min after which CPR was initiated and continued for 8 min before attempting defibrillation. Pigs were randomized to receive 3-mg/kg cariporide (n = 10) or 0.9%-NaCl (n = 10) before chest compression. Results: Seven of 10 pigs in each group were successfully resuscitated and survived 2 h. Cariporide ameliorated post-resuscitation ventricular ectopic activity Such that fewer singlets (5 +/- 5 vs. 26 +/- 21; p < 0.05) and fewer bigemini (1 +/- 3 vs. 33 +/- 25; p < 0.05) were observed during the initial 5 min post-resuscitation. Additionally, cariporide-treated pigs did not require additional post-resuscitation shocks for ventricular tachycardia or recurrent VF (0.0 +/- 0.0 vs. 5.3 +/- 7.8 shocks; p = 0.073). During the initial 60 min cariporide treated pigs had higher, cardiac index (6.1 +/- 0.7 vs. 4.4 +/- 1.1 L/min/m(2); p < 0.01), left ventricular stroke work index (45 +/- 9 vs. 36 +/- 10 gm m/beat/m(2); p < 0.05), and numerically higher mean aortic pressure (104 +/- 11 vs. 91 +/- 12 mmHg; p = 0.054). Conclusion: Cariporide administered at the start of chest compression may help restore electrically and mechanically stable circulation after resuscitation from cardiac arrest. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available