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Post-resuscitation haemodynamics in a novel acute myocardial infarction cardiac arrest model in the pig

Published online by Cambridge University Press:  01 July 2007

T. Palmaers ,
S. Albrecht ,
C. Leuthold ,
F. Heuser ,
J. Schuettler  and
B. Schmitz
T. Palmaers
Affiliation:
Friedrich-Alexander University of Erlangen-Nuremberg, University Hospital Erlangen, Department of Anaesthesiology, Erlangen, Germany
S. Albrecht
Affiliation:
Friedrich-Alexander University of Erlangen-Nuremberg, University Hospital Erlangen, Department of Anaesthesiology, Erlangen, Germany
C. Leuthold
Affiliation:
Friedrich-Alexander University of Erlangen-Nuremberg, University Hospital Erlangen, Department of Anaesthesiology, Erlangen, Germany
F. Heuser
Affiliation:
Friedrich-Alexander University of Erlangen-Nuremberg, University Hospital Erlangen, Department of Anaesthesiology, Erlangen, Germany
J. Schuettler
Affiliation:
Friedrich-Alexander University of Erlangen-Nuremberg, University Hospital Erlangen, Department of Anaesthesiology, Erlangen, Germany
B. Schmitz*
Affiliation:
Friedrich-Alexander University of Erlangen-Nuremberg, University Hospital Erlangen, Department of Anaesthesiology, Erlangen, Germany Centre Hospitalier de Luxembourg, Department of Anesthesiology and Intensive Care Medicine, Luxembourg, Luxembourg
*
Correspondence to: Dr Bernd Schmitz, Département Anesthésie-Réanimation, Centre Hospitalier de Luxembourg, 4, rue Barblé, L-1210 Luxembourg, Luxembourg. E-mail: schmitz.bernd@chl.lu; Tel: +352 4411 2335; Fax: +352 4412 50
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Summary

Background and objectives

Although a considerable amount of promising experimental research has been performed on cardiopulmonary resuscitation, clinical data indicate an ongoing limited outcome in human beings. One reason for this discrepancy could be that experimental studies use healthy animals whereas most human beings undergoing cardiopulmonary resuscitation suffer from acute or chronic myocardial dysfunction. To overcome this problem, we sought to develop a new model of myocardial infarction, that is easy to perform in all kind of laboratories and compromises on the myocardial function significantly.

Methods

Following approval by the local authorities, 14 domestic pigs were instrumented for measurement of arterial, central venous, left atrial and left ventricular pressures. Myocardial infarction was induced in eight pigs by clipping the circumflex artery close to its origin from the left coronary artery (infarction group; n = 8). Six animals (no infarction group, n = 6) served as no-infarct controls. Following a 4-min period of cardiac arrest, internal cardiac massage was performed in these two groups, and haemodynamics were recorded during the first 30 min of reperfusion.

Results

All animals were resuscitated successfully. Compared to the no-infarction group, the infarction group showed significantly decreased myocardial contractility, coronary perfusion pressure and cardiac index (30 min after restoration of spontaneous circulation: infarction group: 57 ± 7 and 89 ± 19 mL min−1 kg−1 in the no-infarction group; mean ± SD; P < 0.05) during reperfusion. Two animals from the infarction group (25%), but none of the animals in the no-infarction group, died during the reperfusion period.

Conclusion

These data demonstrate that clipping of the circumflex artery leads to a reduced myocardial performance after successful resuscitation, whereas the rate of restoration of spontaneous circulation is not reduced. Therefore, this set-up provides a reproducible model for future studies of post-resuscitation haemodynamics and treatment.

Keywords

HEART ARRESTCARDIOPULMONARY RESUSCITATIONMODELS, ANIMAL, pigMYOCARDIAL INFARCTIONREPERFUSION INJURY
Type
EACTA Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 7 , July 2007 , pp. 580 - 588
Copyright
Copyright © European Society of Anaesthesiology 2007

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Footnotes

Presented in part at the German Anaesthesia Congress (DAC 2004) June 2004, Nuremberg, Germany and at the Congress of the European Society of Anaesthesiology (ESA 2004), May 2004, Lisbon, Portugal.

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