Optimizing the duration of CPR prior to defibrillation improves the outcome of CPR in a rat model of prolonged cardiac arrest

Sun, Shijie; Weng, Yinlun; Wu, Xiaobo; Tang, Katherine; Ye, Sen; Chen, Wei; Weil, Max Harry; Tang, Wanchun

doi:10.1016/S0300-9572(11)70144-7

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Volume 82, Supplement 2 , Pages S3-S7, December 2011

Optimizing the duration of CPR prior to defibrillation improves the outcome of CPR in a rat model of prolonged cardiac arrest

Shijie Sun
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Yinlun Weng
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
Xiaobo Wu
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
Katherine Tang
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
Sen Ye
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
Wei Chen
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
Max Harry Weil
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
Wanchun Tang
- Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
- Address for correspondence: Wanchun Tang, MD, Weil Institute of Critical Care Medicine, 35100 Bob Hope Drive, Rancho Mirage, CA 92270, USA. Tel.: +1 760-778-4911; fax: +1 760-778-3468

Abstract

Aims

This study was to investigate whether optimal duration of CPR prior to defibrillation could be guided by Amplitude Spectrum Analysis (AMSA) in the setting of prolonged VF on outcome of CPR.

Methods

VF was induced in thirty Sprague-Dawley rats and untreated for 8 minutes. Animals were then randomized into 3 groups prior to CPR: The duration of CPR prior to defibrillation was guided by AMSA (CC+AMSA); guidelines-based with delayed defibrillation that simulated the AED algorithm (GL+AED); and guidelines-based with immediate shock (GL+shock ready).

Results

Regardless of groups, the majority of the animals (85%) required over 5 min of CPR to achieve restoration of spontaneous circulation (ROSC). Significantly greater rate of ROSC after first defibrillation (70% vs 0%, p < 0.01), lesser CPR interruptions and the number of defibrillations were observed in the CC+AMSA group when compared to both guidelines-based groups (p < 0.001). This was associated with a significantly better post-resuscitation myocardial and neurological function and longer durations of survival.