Effect of cardiopulmonary resuscitation on restoration of myocardial ATP in prolonged ventricular fibrillation.
BACKGROUND
There has been controversy over whether a short period of cardiopulmonary resuscitation (CPR) prior to defibrillation improves survival in patients who experienced a sudden cardiac arrest. However, there have been no reports about whether CPR restores the myocardial energy source during prolonged ventricular fibrillation (VF). The aim of this study is to investigate the effect of CPR in restoring myocardial high energy phosphates during prolonged VF.


RESULTS
Seventy-two adult male Sprague-Dawley rats were used in this study. Baseline adenosine triphosphate (ATP) and adenosine diphosphate (ADP) prior to induction of VF were measured in nine rats, the No-VF group. Sixty-three rats were subjected to 4 min of untreated VF. Animals were then randomized into two groups: No-CPR (n=37) and CPR (n=26). In the No-CPR group, ATPs and ADPs were measured at 4 min (No-CPR4), 6 min (No-CPR6), 8 min (No-CPR8) or 10 min (No-CPR10) after the induction of VF. The CPR group received 2 min (CPR2), 4 min (CPR4) or 6 min (CPR6) of mechanical chest compressions before ATP was measured. Myocardial ATP (nmol/mg protein) was decreased as VF duration was prolonged (No-VF: 5.49±1.71, No-CPR4: 4.27±1.58, No-CPR6: 4.13±1.31, No-CPR8: 3.77±1.42, No-CPR10: 3.52±0.90, p<0.05 between each of No-CPRs vs. No-VF). Two minutes of CPR restored myocardial ATP to the level of No-VF group (5.27±1.67 nmol/mg protein in CPR2, p>0.05 vs. No-VF group). However, myocardial ATP (nmol/mg protein) decreased if the duration of CPR was longer than 2 min (CPR4: 3.77±1.05, CPR6: 3.49±1.08, p<0.05 between CPR4 and CPR6 vs. No-VF).


CONCLUSIONS
CPR for 2 min helps to maintain myocardial ATP after prolonged VF.
Department of Emergency Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea.
Han Joo
HJ
Choi
Tuyet
T
Nguyen
Kyu Sang
KS
Park
Kyoung Chul
KC
Cha
Hyun
H
Kim
Kang Hyun
KH
Lee
Sung Oh
SO
Hwang
D000244:Adenosine Diphosphate / Q000378:metabolism; D000255:Adenosine Triphosphate / Q000378:metabolism*; D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004195:Disease Models, Animal; D008297:Male; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D018709:Statistics, Nonparametric; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy*
D000244:Adenosine Diphosphate; D000255:Adenosine Triphosphate