Open AccessCorrelation of end tidal carbon dioxide, amplitude spectrum area, and coronary perfusion pressure in a porcine model of cardiac arrest
Author(s) -
Segal Nicolas,
Metzger Anja K,
Moore Johanna C.,
India Laura,
Lick Michael C.,
Berger Paul S.,
Tang Wanchun,
Benditt David G.,
Lurie Keith G.
Publication year - 2017
Publication title -
physiological reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 39
ISSN - 2051-817X
DOI - 10.14814/phy2.13401
Subject(s) - coronary perfusion pressure , medicine , ventricular fibrillation , defibrillation , cardiopulmonary resuscitation , cardiology , hemodynamics , perfusion , anesthesia , resuscitation
Abstract Amplitude Spectrum Area ( AMSA ) values during ventricular fibrillation ( VF ) correlate with myocardial energy stores and predict defibrillation success. By contrast, end tidal CO 2 ( ETCO 2) values provide a noninvasive assessment of coronary perfusion pressure and myocardial perfusion during cardiopulmonary resuscitation ( CPR ). Given the importance of the timing of defibrillation shock delivery on clinical outcome, we tested the hypothesis that AMSA and ETCO 2 correlate with each other and can be used interchangably to correlate with myocardial perfusion in an animal laboratory preclinical, randomized, prospective investigation. After 6 min of untreated VF , 12 female pigs (32 ± 1 Kg), isoflurane anesthetized pigs received sequentially 3 min periods of standard (S) CPR , S‐ CPR + an impedance threshold device ( ITD ), and then active compression decompression ( ACD ) + ITD CPR . Hemodynamic, AMSA , and ETCO 2 measurements were made with each method of CPR . The Spearman correlation and Friedman tests were used to compare hemodynamic parameters. ETCO 2, AMSA , coronary perfusion pressure, cerebral perfusion pressure were lowest with STD CPR , increased with STD CPR + ITD and highest with ACD CPR + ITD . Further analysis demonstrated a positive correlation between AMSA and ETCO 2 ( r = 0.37, P = 0.025) and between AMSA and key hemodynamic parameters ( P < 0.05). This study established a moderate positive correlation between ETCO 2 and AMSA . These findings provide the physiological basis for developing and testing a novel noninvasive method that utilizes either ETCO 2 alone or the combination of ETCO 2 and AMSA to predict when defibrillation might be successful.