[Effects of interrupted abdominal aorta compression on cardiopulmonary cerebral resuscitation after cardiac arrest in rabbit]

Abstract

Objective: To explore the effect of the interrupted abdominal aorta compression after cardiopulmonary resuscitation (IAAC-CPR) on cardiopulmonary cerebral resuscitation in a rabbit model of cardiac arrest (CA).

Methods: According to the random number table, 10 New Zealand rabbits of both genders were equally divided into the chest compression-cardiopulmonary resuscitation (CC-CPR) group or IAAC-CPR group, with 5 rabbits in each group. CA model was reproduced by injection of iced-potassium chloride into the jugular vein and obstruction of trachea to produce asphyxia. CA was maintained for 3 minutes before cardiopulmonary resuscitation(CPR). CC-CPR was performed with assisted ventilation + chest compression, while IAAC-CPR was performed by the way of assisted ventilation + chest compressions + compressions on abdominal aorta. The hemodynamics and cerebral cortex blood flow were observed during resuscitation. Time of return of spontaneous circulation (ROSC), 24-hour survival rates, and scores of neurological function, and situation of abdominal organs were recorded.

Results: At 30, 60, 90 and 120 seconds after CPR, the cerebral blood flow (CBF, PU value) and mean arterial pressure (MAP, mmHg, 1 mmHg=0.133 kPa) of IAAC-CPR group were significantly higher than those of CC-CPR group (CBF 30 seconds: 16.1 ± 6.0 vs. 7.8 ± 2.2, 60 seconds: 91.6 ± 11.8 vs. 57.3 ± 23.2, 90 seconds: 259.9 ± 74.9 vs. 163.6 ± 50.3, 120 seconds: 301.5 ± 60.5 vs. 208.4 ± 23.8; MAP 30 seconds: 46.4 ± 9.4 vs. 31.4 ± 8.7, 60 seconds: 55.8 ± 13.8 vs. 34.0 ± 11.5, 90 seconds: 61.2 ± 11.5 vs. 38.2 ± 10.1, 120 seconds: 63.6 ± 11.8 vs. 40.2 ± 10.2, all P<0.05). Compared with CC-CPR group, in IAAC - CPR group, the time necessary for ROSC was obviously shortened (seconds: 182.0 ± 59.0 vs. 312.6 ± 86.6, t=2.787, P=0.024), 24-hour nerve function score was significantly lowered (2.4 ± 1.7 vs. 4.6 ± 0.6, t = 2.974, P = 0.023). The successful recovery rate (80.0% vs. 60.0%, χ² = 0.000, P=1.000) and 24-hour survival rate (80.0% vs. 40.0%, χ² = 0.417, P=0.519) were significantly increased, but without statistical significance. No liver damage was found at 24 hours after ROSC.

Conclusions: In the early recovery of CA in rabbit, IAAC-CPR can result in better cerebral blood flow perfusion as compared with CC-CPR, and it significantly reduced damage to the nervous system function without producing abdominal organ damage.