ArticleCritical care (London, England)2015
Inhaled nitric oxide improves transpulmonary blood flow and clinical outcomes after prolonged cardiac arrest: a large animal study.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 42 citations in OpenAlex.
- Outcomes and characteristics of cardiac arrest in children with pulmonary hypertension: A secondary analysis of the ICU-RESUS clinical trial.Resuscitation · 2023Trial
- Brain neurovascular unit biomarkers: a hypothesis-driven paradigm to advance understanding of post-cardiac arrest cerebral injury.Annals of intensive care · 2026Review
- Multifaceted role of nitric oxide in vascular dementia.Medical gas research · 2025Review
- Comparison of mechanical resuscitation by an LV Impella device to extracorporeal resuscitation using VAECMO in a large animal model.Scientific reports · 2025Article
- Innovative hydrogel-based therapies for ischemia-reperfusion injury： bridging the gap between pathophysiology and treatment.Materials today. Bio · 2024Review
- The Self-Expandable Impella CP (ECP) as a Mechanical Resuscitation Device.Bioengineering (Basel, Switzerland) · 2024Article
- Review
- Nitric oxide: Clinical applications in critically ill patients.Nitric oxide : biology and chemistry · 2022Review
- Pulmonary hypertension among children with in-hospital cardiac arrest: A multicenter study.Resuscitation · 2021Article
- A randomized and blinded trial of inhaled nitric oxide in a piglet model of pediatric cardiopulmonary resuscitation.Resuscitation · 2021Article
- Inhaled nitric oxide preserves ventricular function during resuscitation using a percutaneous mechanical circulatory support device in a porcine cardiac arrest model: an echocardiographic myocardial work analysis.BMC cardiovascular disorders · 2021Article
- Inhaled pulmonary vasodilators: a narrative review.Annals of translational medicine · 2021Review
- Prevalence and Outcomes of Pediatric In-Hospital Cardiac Arrest Associated With Pulmonary Hypertension.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2020Article
- Inhaled Gases as Therapies for Post-Cardiac Arrest Syndrome: A Narrative Review of Recent Developments.Frontiers in medicine · 2020Review
- Depletion of Vascular Nitric Oxide Contributes to Poor Outcomes after Cardiac Arrest.American journal of respiratory and critical care medicine · 2019Article
- Improvement in Outcomes After Cardiac Arrest and Resuscitation by Inhibition of S-Nitrosoglutathione Reductase.Circulation · 2019Article
- Inhaled nitric oxide.British journal of pharmacology · 2019Review
- A pilot study on the kinetics of metabolites and microvascular cutaneous effects of nitric oxide inhalation in healthy volunteers.PloS one · 2019Article
- Effects of inhaled nitric oxide on outcome after prolonged cardiac arrest in mild therapeutic hypothermia treated rats.Scientific reports · 2018Article
- Pulmonary Vasodilator Therapy in Shock-associated Cardiac Arrest.American journal of respiratory and critical care medicine · 2018Article
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
introductionThe probability to achieve a return of spontaneous circulation (ROSC) after cardiac arrest can be improved by optimizing circulation during cardiopulomonary resuscitation using a percutaneous left ventricular assist device (iCPR). Inhaled nitric oxide may facilitate transpulmonary blood flow during iCPR and may therefore improve organ perfusion and outcome.
methodsVentricular fibrillation was electrically induced in 20 anesthetized male pigs. Animals were left untreated for 10 minutes before iCPR was attempted. Subjects received either 20 ppm of inhaled nitric oxide (iNO, n = 10) or 0 ppm iNO (Control, n = 10), simultaneously started with iCPR until 5 hours following ROSC. Animals were weaned from the respirator and followed up for five days using overall performance categories (OPC) and a spatial memory task. On day six, all animals were anesthetized again, and brains were harvested for neurohistopathologic evaluation.
resultsAll animals in both groups achieved ROSC. Administration of iNO markedly increased iCPR flow during CPR (iNO: 1.81 ± 0.30 vs CONTROL: 1.64 ± 0.51 L/min, p < 0.001), leading to significantly higher coronary perfusion pressure (CPP) during the 6 minutes of CPR (25 ± 13 vs 16 ± 6 mmHg, p = 0.002). iNO-treated animals showed significantly lower S-100 serum levels thirty minutes post ROSC (0.26 ± 0.09 vs 0.38 ± 0.15 ng/mL, p = 0.048), as well as lower blood glucose levels 120-360 minutes following ROSC. Lower S-100 serum levels were reflected by superior clinical outcome of iNO-treated animals as estimated with OPC (3 ± 2 vs. 5 ± 1, p = 0.036 on days 3 to 5). Three out of ten iNO-treated, but none of the CONTROL animals were able to successfully participate in the spatial memory task. Neurohistopathological examination of vulnerable cerebral structures revealed a trend towards less cerebral lesions in neocortex, archicortex, and striatum in iNO-treated animals compared to CONTROLs.
conclusionsIn pigs resuscitated with mechanically-assisted CPR from prolonged cardiac arrest, the administration of 20 ppm iNO during and following iCPR improved transpulmonary blood flow, leading to improved clinical neurological outcomes.
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