Ethyl pyruvate enhances intra-resuscitation hemodynamics in prolonged ventricular fibrillation arrest

Brian P. Suffoletto*, David D. Salcido, Eric S. Logue, Timothy W. Caprio, James J. Menegazzi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Aims: As the duration of untreated cardiac arrest increases, the effectiveness of standard therapies declines, and may be more harmful than helpful. We investigated the hemodynamic, metabolic and anti-inflammatory effects of Ringer's ethyl pyruvate solution (REPS) versus Ringer's solution (RS) in the acute model of prolonged porcine arrest. Methods: Seventeen mixed-breed swine were induced into ventricular fibrillation (VF) and left untreated for 8 min. CPR was begun using a mechanical chest compression device at a rate of 100 per minute. At the onset of CPR, animals were randomly assigned to treatment with either 25 mL/kg of RS or 25 mL/kg of REPS containing 40 mg/kg of ethyl pyruvate, infused over 5 min in blinded fashion. CPR continued with administration of a drug cocktail at 2 min and the first rescue shock was delivered at minute 13 of VF. Animals having ROSC were supported with standardized care for 2 h. Results: Both groups had 100% ROSC and 100% 2-h survival. The REPS group exhibited higher median CPP (27.3 mmHg) than the control group (16.5 mmHg) by 3 min of CPR, which continued throughout the duration of CPR (p = 0.02). The median time to hypotension following ROSC was 9.64 min in the REPS group and 7.25 min in controls (p = 0.04) and there was a non-significant trend of decreased use of vasopressors for the duration of resuscitation. There was no difference in systemic or cerebral metabolism between groups. There were non-significant trends of decreased IL-6, increased Il-10 and decreased mesenteric bacterial colony growth in those treated with REPS when compared to RS. Conclusions: The administration of REPS with CPR significantly improved intra- and post-resuscitation hemodynamics in this swine model of prolonged cardiac arrest, but did not definitely change the metabolic or inflammatory profile during the acute resuscitation period.

Original languageEnglish (US)
Pages (from-to)1411-1416
Number of pages6
JournalResuscitation
Volume80
Issue number12
DOIs
StatePublished - Dec 1 2009

Keywords

  • Cardiac
  • Cardiopulmonary resuscitation
  • Coronary perfusion pressure
  • Death
  • Ethyl pyruvate
  • Sudden

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

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