Evaluating the effectiveness of resuscitation with extracorporeal membrane oxygenation in a model of acute hypoxic cardiac arrest in pigs (experimental study)


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Cardiopulmonary resuscitation (CPR) with closed-chest cardiac massage was developed to maintain circulation and ventilation until life-threatening problems could be corrected or reversed. Studies on the effect of CPR have shown that about 80-95 % cases of resuscitation are fatal or severe neurological consequences and survival to discharge after CPR ranged from 6 to 22 % [2, 4, 8, 11]. Furthermore, the chances of survival decline rapidly if the resuscitation period more than 10 minute. At the same time, we know that successful neurologic outcomes are inversely associated with the time of brain hypoperfusion. Because of the low survival rate after prolonged CPR, more aggressive methods have been suggested to increase success. With the advancement of techniques, extracorporeal mechanical support has been applied in conjunction with CPR, with variable results [5, 12]. To assess the efficacy of resuscitation with extracorporeal membrane oxygenation was modeled the acute hypoxic cardiac arrest in pigs. Results of the study in the two groups demonstrate efficient switching method supporting circulatory support (ECMO) in the minutes of CPR. In the provision of an extended set of measures of cardiopulmonary resuscitation in the modeling of hypoxic cardiac arrest in animals in the group with ECMO received great survival to the end of the experiment, less expressed manifestations of acute heart failure. Intergroup comparison given the prerequisites for the development of protocols with the use of ECMO CPR, which would reduce the number of complications and death in patients undergoing cardiac surgery.

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作者简介

Gennadiy Khubulava

Saint Petersburg State Pediatric Medical University

MD, PhD, Dr Med Sci, Professor. Department of Сardiac Surgery

Aleksey Naumov

Saint Petersburg State Pediatric Medical University

Email: naumov99@gmail.com
MD, PhD, Associate Professor Department of Anaesthesiology and Resuscitation

Sergey Marchenko

Saint Petersburg State Pediatric Medical University

Email: sergeimarchenkospb@gmail.com
MD, PhD, Dr Med Sci, Professor, Department of Cardiac Surgery

Vitaliy Suvorov

Saint Petersburg State Pediatric Medical University

Email: vitalikkrak@gmail.com
Assistant Professor, Department of Cardiac Surgery

Igor Averkin

Saint Petersburg State Pediatric Medical University

Email: averkin.igor@gmail.com
Assistant Professor, Department of Cardiac Surgery

Oksana Nevmerzhitskaya

Saint Petersburg State Pediatric Medical University

Email: ovnevmer@gmail.com
MD, PhD, Chief of Neonatology

Vladimir Zaytsev

Saint Petersburg State Pediatric Medical University

Email: doktor812@rambler.ru
Assistant Professor, Department of Cardiac Surgery

Anastasiya Seliverstova

Saint Petersburg State Pediatric Medical University

Email: alisa-0072006@yandex.ru
Assistant Professor, Department of Cardiac Surgery

Vadim Andreyev

Saint Petersburg State Pediatric Medical University

Email: smpgmu@mail.ru
Assistant Professor, Department of Anesthesiology and Resuscitation

Sergey Vlasenko

City hospital N 40

Email: vlasenko@gmail.com
MD, PhD

参考

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  2. De Mos N., Van Litsenburg R. R., McCrindle B. et al. Pediatric in intensive care unit cardiac arrest: incidence, survival, and predictive factors. Crit. Care Med. 2006; 34 (4): 1209-15.
  3. Dembitsky W. P., Moreno-Cabral R. J., Adamson R. M. et al. Emergency resuscitation using portable extracorporeal membrane oxygenation. Ann. Thorac. Surg. 1993; 55: 304-9.
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  6. Nadkarni V. M., Larkin Gl., Pederdy M. A. et al. National registry of cardiopulmonary resuscitation investigators. First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults. JAMA. 2006; 295 (1): 50-7.
  7. Ravishankar C., Dominguez T. E., Kreutzer J. et al. Extracorporeal membrane oxygenation after stage I reconstruction for hypoplastic left heart syndrome. Pediatr. Crit. Care Med. 2006; 7 (4): 319-23.
  8. Shindler M. B., Bohn D., Cox P. N. et al. Outcome of out of hospital cardiac or respiratery arrest in children. N. Engl. J. Med. 1996; 335 (20): 1473-9.
  9. Tunstall-Pedoe H., Bailey L., Chamberlain D. A. et al. Survey of 3765 cardiopulmonary resuscitations in British hospitals (the BRESUS Study): methods and overall results. BMJ. 1992; 304 (6838): 1347-51.
  10. Young K. D., Seidel J. S. Pediatric cardiopulmonary resuscitation: a collective review. Ann. Emerg. Med. 1999; 33 (2): 195-205.
  11. Younger J. G., Schreiner R. J., Swaniker F. et al. Extracorporeal resuscitation of cardiac arrest. Acad. Emerg. Med. 1999; 6: 700-7.
  12. Zaritsky A., Nadkarni V., Geston P. et al. CPR in children. Ann. Emerg. Med. 1987; 16 (10): 1107-11.

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版权所有 © Khubulava G.G., Naumov A.B., Marchenko S.P., Suvorov V.V., Averkin I.I., Nevmerzhitskaya O.V., Zaytsev V.V., Seliverstova A.A., Andreyev V.V., Vlasenko S.V., 2014

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