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Selective perfusion method shows promise in traumatic cardiac arrest model

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – For patients who experience cardiac arrest following blunt trauma, survival is dismal. In the November issue of Critical Care Medicine, researchers report on a selective perfusion method that successfully restored cardiovascular function in an animal model of traumatic cardiac arrest.

The perfusion method, known as selective aortic arch perfusion (SAAP), involves cannulating the femoral artery and subsequent balloon occlusion of the thoracic aorta. Various oxygen-carrying perfusates and drugs can then be delivered to the aortic arch and, ultimately, to the heart and brain.

In the current study, Dr. James E. Manning, from the University of North Carolina at Chapel Hill, and colleagues tested SAAP with a hemoglobin-based oxygen carrier (HBOC-201) and with an oxygenated lactated Ringer's (LR) solution in a swine model of exsanguinating cardiac arrest.

All six swine in the HBOC group experienced return of spontaneous circulation with a sustained mean aortic pressure of 60 mm Hg, the investigators note. Furthermore, none of these swine required epinephrine to achieve this effect. In contrast, none of the swine in the LR group demonstrated return of spontaneous circulation without epinephrine and only two experienced a brief return after epinephrine was given.

Five of six swine in the HBOC group, but none of six in the LR group, were alive 1 hour after exsanguination (p < 0.05), the researchers state.

"SAAP with oxygenated HBOC-201 may provide the critical oxygenation and perfusion support necessary for successful resuscitation from exsanguinating cardiac arrest and sustained short-term survival until potentially life-saving surgery can be performed," Dr. Manning's group concludes.

However, further studies are needed to determine whether the acute benefits of SAAP-HBOC therapy translate into improved long-term outcomes.

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