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Novel Interventions in Cardiac Arrest [Elektronisk resurs] Targeted Temperature Management, Methylene Blue, S-PBN, Amiodarone, Milrinone and Esmolol,  Endothelin and Nitric Oxide In Porcine Resuscitation Models

Zoerner, Frank 1973- (författare)
Lennmyr, Fredrik (preses)
Martijn, Cécile (preses)
Wiklund, Lars (preses)
Gisvold, Sven Erik (opponent)
Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet (utgivare)
Uppsala Uppsala universitet 2015
Engelska 102
Serie: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1651-6206
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  • E-bokAvhandling(Diss. (sammanfattning) Uppsala : Uppsala universitet, 2015)
Sammanfattning Ämnesord
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  • It is a major clinical problem that survival rates after out-of-hospital cardiac arrest have not markedly improved during the last decades, despite extensive research and the introduction of new interventions. However, recent studies have demonstrated promising treatments such as targeted temperature management (TTM) and methylene blue (MB). In our first study, we investigated the effect of MB administered during experi-mental cardiopulmonary resuscitation (CPR) in the setting of postponed hypother-mia in piglets. We set out to study if MB could compensate for a delay to establish targeted TTM. The study demonstrated that MB more than compensated for 30 min delay in induction of TTM. The effect of MB added to that of TTM. The second study examined the effects of TTM and S-PBN on the endothelin system and nitric oxide synthases (NOS) after prolonged CA in a porcine CPR mod-el. The study was designed to understand the cardioprotective mechanism of S-PBN and TTM by their influence on the endothelin system and NOS regulation. We veri-fied for the first time, that these two cardioprotective postresuscitative interventions activate endothelin-1 and its receptors concomitantly with eNOS and nNOS in the myocardium. We concluded that nitric oxide and endothelin pathways are implicated in the postresuscitative cardioprotective effects of TTM. The third study compared survival and hemodynamic effects of low-dose amio-darone and vasopressin to vasopressin in a porcine hypovolemic CA model. The study was designed to evaluate whether resuscitation with amiodarone and vasopressin compared to vasopressin alone would have an impact on resuscitation success, survival, and hemodynamic parameters after hemorrhagic CA. We found that combined resuscitation with amiodarone and vasopressin after hemorrhagic circulatory arrest resulted in greater 3-hour survival, better preserved hemodynamic parameters and smaller myocardial injury compared to resuscitation with vasopressin only. In our fourth study we planned to compare hemodynamic parameters between the treatment group (milrinone, esmolol and vasopressin; MEV) and control group (vasopressin only) during resuscitation from prolonged cardiac arrest in piglets. The study was designed to demonstrate if MEV treatment improved hemodynamics or cardiac damage compared to controls. We demonstrated that MEV treatment reduced cardiac injury compared with vasopressin alone. 

Ämnesord

Medical and Health Sciences  (hsv)
Clinical Medicine  (hsv)
Anesthesiology and Intensive Care  (hsv)
Medicin och hälsovetenskap  (hsv)
Klinisk medicin  (hsv)
Anestesi och intensivvård  (hsv)
Basic Medicine  (hsv)
Cell and Molecular Biology  (hsv)
Medicinska grundvetenskaper  (hsv)
Cell- och molekylärbiologi  (hsv)
Physiology  (hsv)
Fysiologi  (hsv)
Cardiac and Cardiovascular Systems  (hsv)
Kardiologi  (hsv)
Anestesiologi och intensivvård  (uu)
Anaesthesiology and Intensive Care  (uu)
Medical Cell Biology  (uu)
Medicinsk cellbiologi  (uu)
Cardiology  (uu)
Kardiologi  (uu)

Indexterm och SAB-rubrik

restoration of spontaneous circulation
ROSC
cardiopulmonary resuscitation
CPR
cardiac arrest
methylene blue
MB
S-PBN
mild therapeutic hypothermia
MTH
targeted temperature management
TTM
endothelin
ET-1
ECE-1
ETAR
ETBR
nitric oxide
NO
nitric oxide synthase
NOS
eNOS
iNOS
nNOS
porcine
amiodarone
hypovolemia
milrinone
vasopressin
esmolol
epinephrine
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