What question did this study set out to answer?

To determine the optimal flow rate during early reperfusion following one hour of hypothermic ischemic cardiac arrest at 28°C.

January 1, 1982Japanese Circulation Journal-english EditionOpen Access

The optimal flow rate during reperfusion after hypothermic ischemic arrest.

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Why the study?

Does a lower reperfusion flow rate improve myocardial recovery in dogs after hypothermic ischemic arrest compared to higher flow rates?

Population

19 mongrel dogs subjected to cardiopulmonary bypass with ascending aorta clamped for one hour at 28 degrees…

Comparison

Early reperfusion flow rate of 50 ml/kg/min or… vs Early reperfusion flow rate of 80 ml/kg/min for…

Design

Preclinical

Follow-up

60 minutes after declamping of the aorta

Authors

TKTakaaki KamedaKōchi University JAJun AmanoUniversity of North Carolina at Charlotte TOTakao OkamuraImamura Hospital

Discussion

Member takes

Implication

Does not support altering clinical reperfusion protocols; hypothesis-generating for optimal flow in larger ischemia-reperfusion models.

Key Points

To determine the optimal flow rate during early reperfusion following one hour of hypothermic ischemic cardiac arrest at 28°C.
Nineteen mongrel dogs underwent cardiopulmonary bypass and one hour of aortic cross-clamping at a myocardial temperature of 28°C.
Following aortic declamping at 50 mmHg perfusion pressure, animals received 15 minutes of reperfusion at 50 ml/kg/min (Group A, n=6), 80 ml/kg/min (Group B, n=7), or 150 ml/kg/min (Group C, n=6).
Left ventricular function, coronary sinus isoenzymes, myocardial adenosine triphosphate, creatine phosphate, water content, and subendocardial ultrastructure were evaluated.
Mortality during reperfusion was lowest in Group A at 16.7% (1/6), compared with 28.6% (2/7) in Group B and 66.7% (4/6) in Group C.
Group A exhibited the lowest myocardial water content, significantly higher myocardial adenosine triphosphate concentrations, and the lowest left ventricular end-diastolic pressure among all groups.
Subendocardial electron microscopy confirmed preserved cellular ultrastructure in Group A, whereas higher flow rates caused extensive structural deterioration.

Structured PICO

Does a lower reperfusion flow rate improve myocardial recovery in dogs after hypothermic ischemic arrest compared to higher flow rates?

Population

19 mongrel dogs subjected to cardiopulmonary bypass with ascending aorta clamped for one hour at 28 degrees C myocardial temperature.

Intervention

Early reperfusion flow rate of 50 ml/kg/min (Group A) or 150 ml/kg/min (Group C) for 15 minutes.

Comparator

Early reperfusion flow rate of 80 ml/kg/min (Group B) for 15 minutes.

Outcome

Myocardial recovery assessed by cardiac function, biochemistry (ATP, CP, water content, isoenzymes), and fine structure of the left ventricle.surrogate

A lower flow rate of 50 ml/kg/min during early reperfusion after hypothermic ischemic arrest improves myocardial recovery and reduces mortality in a canine model.

Cite This Study

Kameda et al. (1982) studied this question.

synapsesocial.com/papers/6a89d46a41f4089922bd7ab8 https://doi.org/10.1253/jcj.46.473

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The optimal flow rate during reperfusion after hypothermic ischemic arrest.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

The optimal flow rate during reperfusion after hypothermic ischemic arrest.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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