Related Experiment Video
Updated: May 24, 2026
Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
[Coronary revascularization during cardiopulmonary resuscitation. The bridge code]
A Serrano Moraza1, F Del Nogal Sáez, F Alfonso Manterola
1Medicina de Emergencia Basada en la Evidencia MEBE, España; Servicio de Urgencias Médicas Summa 112, Madrid.
Insights
The coronary origin Bridge Code aids refractory cardiac arrest patients with suspected heart issues. It optimizes resuscitation and post-arrest care, potentially enabling organ donation.
Area of Science:
- Cardiology
- Emergency Medicine
- Critical Care Medicine
Context:
- Cardiac arrest presents significant mortality and morbidity challenges.
- Survivors often experience severe brain dysfunction.
- Current resuscitation guidelines require optimization for specific patient populations.
Purpose:
- To introduce the coronary origin Bridge Code for managing cardiac arrest patients.
- To identify patients with a high likelihood of coronary artery disease as the cause of cardiac arrest.
- To integrate advanced resuscitation techniques and post-arrest care strategies.
Summary:
- The coronary origin Bridge Code, based on international resuscitation recommendations, uses predictive criteria to select patients with suspected coronary causes for refractory cardiac arrest.
- It facilitates mechanical chest compressions, percutaneous coronary intervention (PCI) during cardiopulmonary resuscitation (CPR), early hypothermia, and enhanced post-arrest intensive care.
- In cases of treatment failure, it supports hemodynamic management for potential organ donation.
Impact:
- Improves selection of cardiac arrest patients for targeted interventions.
- Enhances perfusion and organ viability during resuscitation.
- Facilitates timely coronary revascularization and advanced post-arrest care.
- Provides a pathway for organ donation in treatment-refractory cases.
Abstract:
Cardiac arrest is one of the major current challenges, due to both its high incidence and mortality and the fact that it leads to severe brain dysfunction in over half of the survivors. The so-called coronary origin Bridge Code is presented, based on the international resuscitation recommendations (2005, 2010). In accordance with a series of strict predictive criteria, this code makes it possible to: (1) select refractory CPR patients with a high or very high presumption of underlying coronary cause; (2) evacuate the patient using mechanical chest compressors [LucasTM, Autopulse®], maintaining coronary and brain perfusion pressures; (3) allow coronary revascularization access during resuscitation maneuvering (PTCA during ongoing CPR); (4) induce early hypothermia; and (5) facilitate post-cardiac arrest intensive care. In the case of treatment failure, the quality of hemodynamic support makes it possible to establish a second bridge to non-heart beating organ donation.
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