Hypertonic-hyperoncotic solutions reduce the release of cardiac troponin I and s-100 after successful cardiopulmonary resuscitation in pigs.
In some patients, cardiopulmonary resuscitation (CPR) can revive spontaneous circulation (ROSC). However, neurological outcome often remains poor. Hypertonic-hyperoncotic solutions (HHS) have been shown to improve microvascular conductivity after regional and global ischemia. We investigated the effect of infusion of HHS in a porcine CPR model. Cardiac arrest was induced by ventricular fibrillation. Advanced cardiac life support was begun after 4 min of nonintervention and 1 min of basic life support. Upon ROSC, the animals randomly received 125 mL of either normal saline (placebo, n = 8) or 7.2% NaCl and 10% hydroxyethyl starch 200,000/0.5 (HHS, n = 7). Myocardial and cerebral damage were assessed by serum concentrations of cardiac troponin I and astroglial protein S-100, respectively, up to 240 min after ROSC. In all animals, the levels of cardiac troponin I and S-100 increased after ROSC (P < 0.01). This increase was significantly blunted in animals that received HHS instead of placebo. The use of HHS in the setting of CPR may provide a new option in reducing cell damage in postischemic myocardial and cerebral tissues.


CONCLUSIONS
Infusion of hypertonic-hyperoncotic solutions (HHS) after successful cardiopulmonary resuscitation in pigs significantly reduced the release of cardiac troponin I and cerebral protein S-100, which are sensitive and specific markers of cell damage. Treatment with HHS may provide a new option to improve the outcome of cardiopulmonary resuscitation.
D000818:Animals; D015415:Biomarkers; D016887:Cardiopulmonary Resuscitation; D004554:Electric Countershock; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics / Q000502:physiology; D006454:Hemoglobins / Q000378:metabolism; D006982:Hypertonic Solutions / Q000627:therapeutic use*; D007511:Ischemia / Q000188:drug therapy; D008297:Male; D015427:Reperfusion Injury / Q000628:therapy; D009418:S100 Proteins / Q000378:metabolism*; D013552:Swine; D019210:Troponin I / Q000378:metabolism*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D015415:Biomarkers; D006454:Hemoglobins; D006982:Hypertonic Solutions; D009418:S100 Proteins; D019210:Troponin I; D014662:Vasoconstrictor Agents; D004837:Epinephrine