Blood flow in the cerebral cortex during cardiac resuscitation in dogs

Regional cerebral cortical blood flow (rCCBF) in 15 large dogs was determined using the double thermistor dilution method during standard closed-chest massage (CCM), CCM with an epinephrine infusion at 30 micrograms/kg/min (CCM + Epi), and open-chest cardiac massage (OCCM). As a percentage of prearrest flow values, the rCCBF was 9.8% with CCM, 35% with CCM + Epi, and 156% with OCCM. The rCCBF was reduced significantly with CCM (P less than .005) and CCM + Epi (P less than .01). OCCM generated flows indistinguishable from prearrest values. The use of high-dose epinephrine significantly increased the rCCBF during CCM. The implications for intact neurologic resuscitation of these reductions in rCCBF with CCM are important.