ArticleCritical care medicine2019
Hemodynamic-Directed Cardiopulmonary Resuscitation Improves Neurologic Outcomes and Mitochondrial Function in the Heart and Brain.
Article in Critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
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Who cites it
44 citing papers in PubMed.
- Chest compressions superimposed with sustained inflations during cardiopulmonary resuscitation in asphyxiated pediatric piglets.Pediatric research · 2024Trial
- Prediction of Shock-Refractory Ventricular Fibrillation During Resuscitation of Out-of-Hospital Cardiac Arrest.Circulation · 2023Trial
- Chest compression synchronized ventilation versus chest compression asynchronized ventilation in asphyxiated pediatric piglets-a randomized animal trial.Pediatric research · 2026Article
- Advanced resuscitative interventions in refractory out-of-hospital cardiac arrest: a retrospective cohort study of a physician-led pre-hospital team.Resuscitation plus · 2026Article
- Key physiological indicators and technological trends in physiology-directed cardiopulmonary resuscitation: A narrative review.Resuscitation plus · 2026Review
- Evaluation of coronary perfusion pressure and diastolic blood pressure calculation methods in a swine model of pediatric cardiopulmonary resuscitation.Resuscitation plus · 2025Article
- A novel translational bioinformatics framework for facilitating multimodal data analyses in preclinical models of neurological injury.Scientific reports · 2024Article
- Amplitude spectrum area is dependent on the electrocardiogram magnitude: evaluation of different normalization approaches.Physiological measurement · 2024Article
- The association between initial post-resuscitation diastolic blood pressure and survival after pediatric cardiac arrest: a retrospective study.BMC pediatrics · 2024Article
- Elevated serum neurologic biomarker profiles after cardiac arrest in a porcine model.Resuscitation plus · 2024Article
- Effect of dimethyl fumarate on mitochondrial metabolism in a pediatric porcine model of asphyxia-induced in-hospital cardiac arrest.Scientific reports · 2024Article
- Wolf Creek XVII Part 6: Physiology-Guided CPR.Resuscitation plus · 2024Review
- Animal research in cardiac arrest.Resuscitation plus · 2024Review
- Wolf Creek XVII part 9: Wolf Creek Innovator in Cardiac Arrest and Resuscitation Science Award.Resuscitation plus · 2024Review
- Associations Between End-Tidal Carbon Dioxide During Pediatric Cardiopulmonary Resuscitation, Cardiopulmonary Resuscitation Quality, and Survival.Circulation · 2024Observational
- Carbon monoxide as a cellular protective agent in a swine model of cardiac arrest protocol.PloS one · 2024Article
- Prediction of Return of Spontaneous Circulation in a Pediatric Swine Model of Cardiac Arrest Using Low-Resolution Multimodal Physiological Waveforms.IEEE journal of biomedical and health informatics · 2023Article
- Clinician-reported physiologic monitoring of cardiopulmonary resuscitation quality during pediatric in-hospital cardiac arrest: A propensity-weighted cohort study.Resuscitation · 2023Article
- Thiamine for the Treatment of Cardiac Arrest-Induced Neurological Injury: A Randomized, Blinded, Placebo-Controlled Experimental Study.Journal of the American Heart Association · 2023Article
- The physiologic response to epinephrine and pediatric cardiopulmonary resuscitation outcomes.Critical care (London, England) · 2023Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectivesLess than half of the thousands of children who suffer in-hospital cardiac arrests annually survive, and neurologic injury is common among survivors. Hemodynamic-directed cardiopulmonary resuscitation improves short-term survival, but its impact on longer term survival and mitochondrial respiration-a potential neurotherapeutic target-remains unknown. The primary objectives of this study were to compare rates of 24-hour survival with favorable neurologic outcome after cardiac arrest treated with hemodynamic-directed cardiopulmonary resuscitation versus standard depth-guided cardiopulmonary resuscitation and to compare brain and heart mitochondrial respiration between groups 24 hours after resuscitation.
designRandomized preclinical large animal trial.
settingA large animal resuscitation laboratory at a large academic children's hospital. SUBJECTS: Twenty-eight 4-week-old female piglets (8-11 kg).
interventionsTwenty-two swine underwent 7 minutes of asphyxia followed by ventricular fibrillation and randomized treatment with either hemodynamic-directed cardiopulmonary resuscitation (n = 10; compression depth titrated to aortic systolic pressure of 90 mm Hg, vasopressors titrated to coronary perfusion pressure ≥ 20 mm Hg) or depth-guided cardiopulmonary resuscitation (n = 12; depth 1/3 chest diameter, epinephrine every 4 min). Six animals (sham group) underwent anesthesia and instrumentation without cardiac arrest. The primary outcomes were favorable neurologic outcome (swine Cerebral Performance Category ≤ 2) and mitochondrial maximal oxidative phosphorylation utilizing substrate for complex I and complex II (OXPHOSCI+CII) in the cerebral cortex and hippocampus. MEASUREMENTS AND MAIN
resultsFavorable neurologic outcome was more likely with hemodynamic-directed cardiopulmonary resuscitation (7/10) than depth-guided cardiopulmonary resuscitation (1/12; p = 0.006). Hemodynamic-directed cardiopulmonary resuscitation resulted in higher intra-arrest coronary perfusion pressure, aortic pressures, and brain tissue oxygenation. Hemodynamic-directed cardiopulmonary resuscitation resulted in higher OXPHOSCI+CII (pmol oxygen/s × mg/citrate synthase) in the cortex (6.00 ± 0.28 vs 3.88 ± 0.43; p < 0.05) and hippocampus (6.26 ± 0.67 vs 3.55 ± 0.65; p < 0.05) and higher complex I respiration (pmol oxygen/s × mg) in the right (20.62 ± 1.06 vs 15.88 ± 0.81; p < 0.05) and left ventricles (20.14 ± 1.40 vs 14.17 ± 1.53; p < 0.05).
conclusionsIn a model of asphyxia-associated pediatric cardiac arrest, hemodynamic-directed cardiopulmonary resuscitation increases rates of 24-hour survival with favorable neurologic outcome, intra-arrest hemodynamics, and cerebral and myocardial mitochondrial respiration.
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