Role of Epinephrine and Extracorporeal Membrane Oxygenation in the Management of Ischemic Refractory Ventricular Fibrillation

Jason A. Bartos, MD, PhD; Sebastian Voicu, MD; Timothy R. Matsuura, BA; Adamantios Tsangaris, MD; Georgios Sideris, MD, PhD; Brett A. Oestreich, MD; Stephen A. George, MD, PhD; Matthew Olson, MD; Kadambari Chandra Shekar, MS; Jennifer N. Rees, PhD; Kathleen Carlson, MD; Pierre Sebastian, BBME; Scott McKnite, BS; Ganesh Raveendran, MD; Tom P. Aufderheide, MD; Demetris Yannopoulos, MD

JACC: Basic to Translational Science (Jun 2017)

Role of Epinephrine and Extracorporeal Membrane Oxygenation in the Management of Ischemic Refractory Ventricular Fibrillation

Jason A. Bartos, MD, PhD,
Sebastian Voicu, MD,
Timothy R. Matsuura, BA,
Adamantios Tsangaris, MD,
Georgios Sideris, MD, PhD,
Brett A. Oestreich, MD,
Stephen A. George, MD, PhD,
Matthew Olson, MD,
Kadambari Chandra Shekar, MS,
Jennifer N. Rees, PhD,
Kathleen Carlson, MD,
Pierre Sebastian, BBME,
Scott McKnite, BS,
Ganesh Raveendran, MD,
Tom P. Aufderheide, MD,
Demetris Yannopoulos, MD

Affiliations

Jason A. Bartos, MD, PhD: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Sebastian Voicu, MD: Medical and Toxicological Intensive Care Unit, LariboisiÃ¨re Hospital, APHP, UniversitÃ© Paris Diderot, Paris, France
Timothy R. Matsuura, BA: Department of Integrated Biology & Physiology, University of Minnesota, Minneapolis, Minnesota
Adamantios Tsangaris, MD: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Georgios Sideris, MD, PhD: Department of Cardiology, Lariboisiere Hospital, APHP, UniversitÃ© Paris Diderot, Paris, France
Brett A. Oestreich, MD: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Stephen A. George, MD, PhD: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Matthew Olson, MD: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Kadambari Chandra Shekar, MS: Department of Integrated Biology & Physiology, University of Minnesota, Minneapolis, Minnesota
Jennifer N. Rees, PhD: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Kathleen Carlson, MD: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Pierre Sebastian, BBME: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Scott McKnite, BS: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Ganesh Raveendran, MD: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Tom P. Aufderheide, MD: Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Demetris Yannopoulos, MD: Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Address for correspondence: Dr. Demetris Yannopoulos, University of Minnesota, UMNâCardiology Division, 420 Delaware Street Southeast, MMC 508, Minneapolis, Minnesota 55455.

Journal volume & issue: Vol. 2, no. 3
pp. 244 – 253

Abstract

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Summary: Extracorporeal membrane oxygenation (ECMO) is used in cardiopulmonary resuscitation (CPR) of refractory cardiac arrest. The authors used a 2Â Ã 2 study design to compare ECMO versus CPR and epinephrine versus placebo in a porcine model of ischemic refractory ventricular fibrillation (VF). Pigs underwent 5 min of untreated VF and 10 min of CPR, and were randomized to receive epinephrine versus placebo for another 35 min. Animals were further randomized to left anterior descending artery (LAD) reperfusion at minute 45 with ongoing CPR versus venoarterial ECMO cannulation at minute 45 of CPR and subsequent LAD reperfusion. Four-hour survival was improved withÂ ECMO whereas epinephrine showed no effect. Key Words: advanced cardiopulmonary life support, cardiac arrest, cardiopulmonary resuscitation, ECMO, extracorporeal membrane oxygenation, ischemic refractory ventricular fibrillation, ST-segment elevation myocardial infarction, ventricular fibrillation

Published in JACC: Basic to Translational Science

ISSN: 2452-302X (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jacc-basic-to-translational-science/

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