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Adrenaline improves regional cerebral blood flow, cerebral oxygenation and cerebral metabolism during CPR in a porcine cardiac arrest model using low-flow extracorporeal support

Gabriel Putzer, Judith Martini, Patrick Spraider, Julia Abram, Rouven Hornung, Christine R. Schmidt, Marlies Bauer, Daniel Pinggera, Christoph Krapf, Tobias Hell, Bernhard Glodny, Raimund Helbok, Peter Mair

2021Resuscitation32 citationsDOIOpen Access PDF

Abstract

BACKGROUND: The effects of adrenaline on cerebral blood vessels during cardiopulmonary resuscitation (CPR) are not well understood. We developed an extracorporeal CPR model that maintains constant low systemic blood flow while allowing adrenaline-associated effects on cerebral vasculature to be assessed at different mean arterial pressure (MAP) levels independently of the effects on systemic blood flow. METHODS: ) and extracellular cerebral metabolites assessed by cerebral microdialysis. RESULTS: to 15 ± 11% and 130 ± 82% (both p < 0.001) of baseline in the MAP 40 mmHg and MAP 60 mmHg groups, respectively. Importantly, MAP of 60 mmHg was associated with metabolic improvement. CONCLUSION: This study shows that adrenaline administration during constant low systemic blood flow increases CePP, regional CBF, cerebral oxygenation and cerebral metabolism.

Topics & Concepts

MedicineCerebral blood flowCerebral perfusion pressureMicrodialysisAnesthesiaMean arterial pressureExtracorporealExtracorporeal cardiopulmonary resuscitationBlood pressureOxygenationCardiopulmonary resuscitationResuscitationBlood flowCerebral autoregulationCardiologyHemodynamicsInternal medicineHeart rateCentral nervous systemAutoregulationCardiac Arrest and ResuscitationTraumatic Brain Injury and Neurovascular DisturbancesCardiac Ischemia and Reperfusion
Adrenaline improves regional cerebral blood flow, cerebral oxygenation and cerebral metabolism during CPR in a porcine cardiac arrest model using low-flow extracorporeal support | Litcius