Selective aortic arch perfusion using serial infusions of perflubron emulsion

Area of Science:

• Cardiovascular Research
• Emergency Medicine
• Experimental Physiology

Background:

• Conventional cardiopulmonary resuscitation (CPR) has limitations in restoring circulation during cardiac arrest.
• Improving coronary perfusion pressure (CPP) is critical for successful resuscitation.

Purpose of the Study:

• To evaluate the efficacy of selective aortic arch perfusion (SAAP) combined with aortic epinephrine (AoE) and oxygenated perflubron emulsion compared to conventional therapy for cardiac arrest.

Main Methods:

• An experimental canine cardiac arrest model was utilized (10 min ventricular fibrillation, 2 min CPR).
• Animals were randomized to either control (CPR + IV epinephrine) or AoE-SAAP (CPR + AoE + serial SAAP with perflubron emulsion).
• SAAP involved continuous infusion followed by pulsed diastolic infusions during CPR.

Main Results:

• The AoE-SAAP group demonstrated significantly increased CPP and return of spontaneous circulation (ROSC) compared to the control group (4/6 vs. 0/6, p < 0.05).
• Pulsed diastolic SAAP achieved CPP levels comparable to or greater than initial continuous SAAP.
• Resuscitated animals in the AoE-SAAP group achieved ROSC with sustained systolic aortic pressure > 60 mm Hg within 8.0 ± 1.2 minutes.

Conclusions:

• Combining aortic epinephrine with selective aortic arch perfusion using oxygenated perflubron emulsion is more effective than conventional resuscitation.
• Pulsed diastolic SAAP represents a viable and promising technique for enhancing resuscitation efforts.