Abstract
We assessed efficacy of conventional CPR in terms of cerebral (CBF) and myocardial (MBF) blood flows in an infant animal model and determined whether epinephrine (EPI) improves CBF and MBF as in adult animals. CPR was performed on pentobarbitalanesthetized piglets (2 weeks old, 4–5 kg) by a pneumatic compressor with 20% sternal displacement, 100 compressions/min, 60% duty cycle, and 1:5 breath to compression ratio. Chest recoil was incomplete, leading to 20% deformation of diameter. CBF (ml·min−1 · 100g−1; microspheres) was 43 ± 4 (± SE; n=8) pre-arrest and 24 ± 7 at 5 min of CPR, but gradually fell further to 5 ± 4 at 50 min. MBF (188 ± 38 pre-arrest) fell from 27 ± 7 at 5 min to 1 ± 1 at 50 min. This was related to a gradual fall in aortic pressure with little change in right atrial or intracranial pressures. A second group of piglets (n=8) received EPI (4 μg/kg/min). CBF at 5 min (46 ± 9) and 20 min (44 ± 10) were not different from pre-arrest (49 ± 5), although CBF still fell by 50 min (11 ± 4) as MABP fell. MBF (65 ± 16, 5 min), CBF, cerebral O2 uptake and perfusion pressure were higher in the EPI group. We conclude that a) conventional CPR in infant piglets without EPI initially provides higher CBF and MBF than in adult animals, which is probably related to the greater chest deformity in young animals, and b) EPI further improves CBF and MBF by constricting other beds.
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Schleien, C., Dean, J., Koehler, R. et al. 209 CEREBRAL AND MYOCARDIAL BLOOD FLOW DURING CPR WITH AND WITHOUT EPINEPHRINE IN PIGLETS. Pediatr Res 19, 145 (1985). https://doi.org/10.1203/00006450-198504000-00239
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DOI: https://doi.org/10.1203/00006450-198504000-00239