Sodium Nitroprusside–Enhanced Cardiopulmonary Resuscitation Improves Blood Flow by Pulmonary Vasodilation Leading to Higher Oxygen Requirements

Adrian Ripeckyj, BA; Marinos Kosmopoulos, MD; Kadambari Shekar, MS; Claire Carlson, DO; Rajat Kalra, MD; Jennifer Rees, PhD; Tom P. Aufderheide, MD, MS; Jason A. Bartos, MD, PhD; Demetris Yannopoulos, MD

JACC: Basic to Translational Science (Feb 2020)

Sodium Nitroprusside–Enhanced Cardiopulmonary Resuscitation Improves Blood Flow by Pulmonary Vasodilation Leading to Higher Oxygen Requirements

Adrian Ripeckyj, BA,
Marinos Kosmopoulos, MD,
Kadambari Shekar, MS,
Claire Carlson, DO,
Rajat Kalra, MD,
Jennifer Rees, PhD,
Tom P. Aufderheide, MD, MS,
Jason A. Bartos, MD, PhD,
Demetris Yannopoulos, MD

Affiliations

Adrian Ripeckyj, BA: Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota
Marinos Kosmopoulos, MD: Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota
Kadambari Shekar, MS: Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota
Claire Carlson, DO: Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota
Rajat Kalra, MD: Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota
Jennifer Rees, PhD: Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota
Tom P. Aufderheide, MD, MS: Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Jason A. Bartos, MD, PhD: Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota; Center for Resuscitation Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota
Demetris Yannopoulos, MD: Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota; Center for Resuscitation Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota; Address for correspondence: Dr. Demetris Yannopoulos, Center for Resuscitation Medicine, Office of Academic Clinical Affairs, University of Minnesota Medical School, 420 Delaware Street, Southeast, MMC 508 Mayo, Minneapolis, Minnesota 55455.

Journal volume & issue: Vol. 5, no. 2
pp. 183 – 192

Abstract

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Summary: Sodium nitroprusside–enhanced cardiopulmonary resuscitation has shown superior resuscitation rates and neurologic outcomes in large animal models supporting the need for a randomized human clinical trial. This study is the first to show nonselective pulmonary vasodilation as a potential mechanism for the hemodynamic benefits. The pulmonary shunting that is created requires increased oxygen treatment, but the overall improvement in blood flow increases minute oxygen delivery to tissues. In this context, hypoxemia is an important safety endpoint and a 100% oxygen ventilation strategy may be necessary for the first human clinical trial. Key Words: cardiopulmonary resuscitation, coronary perfusion pressure, lactic acid, pulmonary vasodilation, sodium nitroprusside

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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