Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb;5(1):56-60.
doi: 10.1002/ame2.12200. Epub 2022 Jan 28.

A comprehensive neuromonitoring approach in a large animal model of cardiac arrest

Filippo Annoni  1 , Lorenzo Peluso  1 , Lucas Akira Hirai  2 , Giovanni Babini  3   4 , Amina Khaldi  1 , Antoine Herpain  1 , Lorenzo Pitisci  1 , Lorenzo Ferlini  1 , Bruno Garcia  1 , Fabio Silvio Taccone  1 , Jacques Creteur  1 , Fuhong Su  1
Affiliations

A comprehensive neuromonitoring approach in a large animal model of cardiac arrest

Filippo Annoni et al. Animal Model Exp Med. 2022 Feb.

Abstract

Background: Anoxic brain injuries represent the main determinant of poor outcome after cardiac arrest (CA). Large animal models have been described to investigate new treatments during CA and post-resuscitation phase, but a detailed model that includes extensive neuromonitoring is lacking.

Method: Before an electrically-induced 10-minute CA and resuscitation, 46 adult pigs underwent neurosurgery for placement of a multifunctional probe (intracranial pressure or ICP, tissue oxygen tension or PbtO2 and cerebral temperature) and a bolt-based technique for the placement and securing of a regional blood flow probe and two sEEG electrodes; two modified cerebral microdialysis (CMD) probes were also inserted in the frontal lobes and accidental misplacement was prevented using a perforated head support.

Result: 42 animals underwent the CA procedure and 41 achieved the return of spontaneous circulation (ROSC). In 4 cases (8.6%) an adverse event took place during preparation, but only in two cases (4.3%) this was related to the neurosurgery. In 6 animals (13.3%) the minor complications that occurred resolved after probe repositioning.

Conclusion: Herein we provide a detailed comprehensive neuromonitoring approach in a large animal model of CA that might help future research.

Keywords: anoxic injury; heart arrest; ischemiareperfusion; post‐arrest; resuscitation.

PubMed Disclaimer

Conflict of interest statement

The Authors have no conflict of interests to declare that compromise the quality of this article.

Figures

FIGURE 1
FIGURE 1
Inverted F incision in the scalp with flaps. Blue lines represent incision lines; blue circles represent areas for skull drilling
FIGURE 2
FIGURE 2
Bolts and modified microdialysis catheters after intracranial placement, before connection to the CNS perfusion pump
FIGURE 3
FIGURE 3
All neuromonitoring probes in place before the start of the experiment. Microdialysis catheters are tunneled in the scalp and four probes are secured to the bolts. sEEG, stereoelectroencephalography; CMD, cerebral microdialysis catheter; CBF, cerebral blood flow probe; ICP, intracranial pressure; Tc, brain temperature; PbtO2, brain oxygen tension
FIGURE 4
FIGURE 4
Animal in position before CA induction. PM, pace maker
See this image and copyright information in PMC

References

    1. Gräsner J‐T, Herlitz J, Tjelmeland IBM, et al. European resuscitation council guidelines 2021: Epidemiology of cardiac arrest in Europe. Resuscitation. 2021;161:61‐79. - PubMed
    1. Lemiale V, Dumas F, Mongardon N, et al. Intensive care unit mortality after cardiac arrest: the relative contribution of shock and brain injury in a large cohort. Intensive Care Med. 2013;39:1972‐1980. - PubMed
    1. Taccone FS, Crippa IA, Dell’Anna AM, Scolletta S. Neuroprotective strategies and neuroprognostication after cardiac arrest. Best Pract Res Clin Anaesthesiol. 2015;29:451‐464. - PubMed
    1. Lascarrou JB, Merdji H, Le Gouge A, et al. Target temperature management for cardiac arrest with no shockable rhythm. N Engl J Med. 2019;381(24):2327‐2337. - PubMed
    1. Olai H, Thornéus G, Watson H, et al. Meta‐analysis of targeted temperature management in animal models of cardiac arrest. Intensive Care Med Exp. 2020;8(3). - PMC - PubMed

Publication types