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| Effect of rapid blood transfusion through aortic arch on hemodynamics during resuscitation in rabbits with exsanguination cardiac arrest |
| Zheng Ru-gang, Zhang Min-hai, Jian Hong-jian, Liang Guo-dong, Zhong Tao, Wu Gang |
| Department of Emergency, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China |
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Abstract Objective We established a rabbit model of exsanguination cardiac arrest (ECA)to simulate the extreme state of haemorrhagic shock, and sought to compare the effects of rapid blood transfusion through the aortic arch with central vein on coronary perfusion pressure (CPP)during resuscitation. Methods Forty-five New Zealand rabbits were divided randomly into three groups: aortic arch transfusion with chest compression (AAT)(n=15), central vein transfusion with chest compression (CVT)(n=15), and simple aortic arch transfusion without chest compression (SAAT)(n=15). Exsanguination cardiac arrest was induced by rapid exsanguination from the left femoral artery and vein. Resuscitation was not initiated until 15 mins passed without any intervention. Rapid blood transfusion from the aortic arch through catheterizing the left femoral artery with (AAT)or without (SAAT)chest compression, and from the venae cava inferior through catheterizing the left femoral vein with chest compression (CVT)were performed. Hemodynamic parameters (SBP, DBP, MAP and CVP)were continuously recorded. CPP was calculated and analyzed at each data Point. Animals were observed for 6 h after restoration of spontaneous circulation (ROSC). Results Mean blood loss was 79.18±11.79 mL. At the 1st, 2nd and 3rd minutes of blood transfusion, group AAT［(61.24±33.00)mm Hg, (75.97±33.72)mm Hg, (73.17±32.74)mm Hg, respectively］and SAAT［(50.32±21.45)mm Hg, (60.93±25.07)mm Hg, (65.65±25.26)mm Hg, respectively］ had significantly higher CPP than CVT［(23.72±16.53)mm Hg, (27.25±21.10)mm Hg, (30.22±19.13)mm Hg, respectively］ (P＜0.001, P＜0.001, P＜0.001, respectively). At the 10 th, 20 th, and 30 th minutes after ROSC, CPP in group AAT［(92.75±25.64)mm Hg, (90.53±26.07)mm Hg, (86.47±20.83)mm Hg, respectively］and SAAT［(81.94±16.16)mm Hg, (84.82±8.92)mm Hg, (84.69±10.57)mm Hg, respectively］ were significantly higher than CVT［(62.36±13.14)mm Hg, (62.94±11.75)mm Hg, (61.06±15.22)mm Hg, respectively］ (P=0.004, P=0.003, P=0.001, respectively). ROSC rate of groups were AAT (12/15)80.0%, CVT (10/15)66.7%, SAAT (12/15)80.0%, respectively, which were not statistically different (P=0.618). Median survival time in groups AAT (5.0±0.41)h and SAAT (4.0±0.34)h was significantly longer than that in CVT (3.0±0.78)h (P=0.027). Conclusion During resuscitation in rabbits with exsanguination cardiac arrest, compared with rapid central vein transfusion, aortic arch transfusion has higher CPP from blood transfusion and after ROSC, and a longer median survival time.
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Corresponding Authors:
Wu Gang, E-mail: wugang_wugang@126.com
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