Head and thorax elevation prevents the rise of intracranial pressure during extracorporeal resuscitation in swine - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Shock Année : 2022

Head and thorax elevation prevents the rise of intracranial pressure during extracorporeal resuscitation in swine

, , , , , , , , , , , , (1, 2, 3)
1
2
3
Yael Levy
  • Fonction : Auteur
Alice Hutin
  • Fonction : Auteur
Nicolas Polge
  • Fonction : Auteur
Fanny Lidouren
  • Fonction : Auteur
Rocio Fernandez
  • Fonction : Auteur
Matthias Kohlhauer
  • Fonction : Auteur
Pierre-Louis Leger
  • Fonction : Auteur
Jérôme Rambaud
  • Fonction : Auteur
Guillaume Debaty
  • Fonction : Auteur
Keith Lurie
  • Fonction : Auteur
Bijan Ghaleh
  • Fonction : Auteur
Lionel Lamhaut
  • Fonction : Auteur

Résumé

Aim: Head and thorax elevation during cardiopulmonary resuscitation improves cerebral hemodynamics and ultimate neurological outcome after cardiac arrest. Its effect during extracorporeal cardiopulmonary resuscitation (E-CPR) is unknown. We tested whether this procedure could improve hemodynamics in swine treated by E-CPR. Methods and Results: Pigs were anesthetized and submitted to 15 minutes of untreated ventricular fibrillation followed by E-CPR. Animals randomly remained in flat position (flat group) or underwent head and thorax elevation since E-CPR institution (head-up group). Electric shocks were delivered after 30 minutes until the return of spontaneous circulation (ROSC). They were followed during 120 minutes after ROSC. After 30 minutes of E-CPR, ROSC was achieved in all animals, with no difference regarding blood pressure, heart rate, and extracorporeal membrane of oxygenation flow among groups. The head-up group had an attenuated increase in ICP as compared with the flat group after cardiac arrest (13 ± 1 vs. 26 ± 2 mm Hg at the end of the follow-up, respectively). Cerebral perfusion pressure tended to be higher in the head-up versus flat group despite not achieving statistical difference (66 ± 1 vs 46 ± 1 mm Hg at the end of the follow-up). Carotid blood flow and cerebral oxygen saturation were not significantly different among groups. Conclusion: During E-CPR, head and thorax elevation prevents ICP increase. Whether it could improve the ultimate neurological outcome in this situation deserves further investigation.
Fichier principal
Vignette du fichier
Head-up ECMO_ 2022-07-14-accepted.pdf (225.82 Ko) Télécharger le fichier
Vignette du fichier
Figure 1.jpg (1.07 Mo) Télécharger le fichier
Vignette du fichier
Figure 2.jpg (1.32 Mo) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)

Dates et versions

hal-03915801 , version 1 (29-12-2022)

Identifiants

Citer

Yael Levy, Alice Hutin, Nicolas Polge, Fanny Lidouren, Rocio Fernandez, et al.. Head and thorax elevation prevents the rise of intracranial pressure during extracorporeal resuscitation in swine. Shock, 2022, 58 (3), pp.236-240. ⟨10.1097/SHK.0000000000001971⟩. ⟨hal-03915801⟩

Collections

IMRB UPEC ENVA ANR
0 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook Twitter LinkedIn More