title: Effects of the administration of 2,3-butanedione monoxime during conventional cardiopulmonary resuscitation on ischaemic contracture and resuscitability in a pig model of out-of-hospital cardiac arrest.
abstract: OBJECTIVE
  Ischaemic contracture compromises the haemodynamic effectiveness of cardiopulmonary resuscitation and resuscitability. 2,3-Butanedione monoxime (BDM) reduced ischaemic contracture by inhibiting actin-myosin crossbridge formation in an isolated heart model. We investigated the effects of BDM on ischaemic contracture and resuscitation outcomes in a pig model of out-of-hospital cardiac arrest (OHCA).
  
  
  METHODS
  After 15min of untreated ventricular fibrillation, followed by 8min of basic life support, 16 pigs were randomised to receive either 2mlkg(-1) of BDM solution (25gl(-1)) or 2mlkg(-1) of saline during advanced cardiac life support (ACLS).
  
  
  RESULTS
  During the ACLS, the control group showed an increase in left ventricular (LV) wall thickness from 10.0mm (10.0-10.8) to 13.0mm (13.0-13.0) and a decrease in LV chamber area from 8.13cm(2) (7.59-9.29) to 7.47cm(2) (5.84-8.43). In contrast, the BDM group showed a decrease in the LV wall thickness from 10mm (9.0-10.8) to 8.5mm (7.0-9.8) and an increase in the LV chamber area from 9.86cm(2) (7.22-12.39) to 12.15 cm(2) (8.02-14.40). Mixed model analyses of the LV wall thickness and LV chamber area revealed significant group effects and group-time interactions. Spontaneous circulation was restored in four (50%) animals in the control group and in eight (100%) animals in the BDM group (p=0.077). All the resuscitated animals survived during an intensive care period of 4h.
  
  
  CONCLUSIONS
  BDM administered during cardiopulmonary resuscitation reversed ischaemic contracture in a pig model of OHCA.
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42, Jebong-ro, Donggu, Gwangju, Republic of Korea. Electronic address: bbukkuk@hanmail.net.
authors.forename: Byung Kook
authors.initials: BK
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42, Jebong-ro, Donggu, Gwangju, Republic of Korea. Electronic address: neoneti@hanmail.net.
authors.forename: Kyung Woon
authors.initials: KW
authors.lastname: Jeung
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42, Jebong-ro, Donggu, Gwangju, Republic of Korea. Electronic address: ranger898@hanmail.net.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Choi
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42, Jebong-ro, Donggu, Gwangju, Republic of Korea. Electronic address: psw4699@hanmail.net.
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Park
authors.affiliation: Department of Emergency Medical Technology, Namseoul university, 91, Daehak-ro, Seonghwan-eup, Sebuk-gu, Cheonan, Republic of Korea. Electronic address: love8654@hanmail.net.
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Yun
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42, Jebong-ro, Donggu, Gwangju, Republic of Korea. Electronic address: magicwizard2@hanmail.net.
authors.forename: Sung Min
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, 42, Jebong-ro, Donggu, Gwangju, Republic of Korea. Electronic address: nanyeolkim@gmail.com.
authors.forename: Nan Yeol
authors.initials: NY
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42, Jebong-ro, Donggu, Gwangju, Republic of Korea. Electronic address: docheo@hanmail.net.
authors.forename: Tag
authors.initials: T
authors.lastname: Heo
authors.affiliation: Department of Emergency Medicine, Chonnam National University Hospital, 42, Jebong-ro, Donggu, Gwangju, Republic of Korea. Electronic address: minyi46@hanmail.net.
authors.forename: Yong Il
authors.initials: YI
authors.lastname: Min
mesh_terms: D022561:Advanced Cardiac Life Support / Q000379:methods*; D000818:Animals; D003931:Diacetyl / Q000031:analogs & derivatives* / Q000494:pharmacology; D004195:Disease Models, Animal; D016903:Drug Monitoring; D004791:Enzyme Inhibitors / Q000494:pharmacology; D006352:Heart Ventricles / Q000187:drug effects / Q000473:pathology; D054061:Ischemic Contracture / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000628:therapy; D013552:Swine; D016896:Treatment Outcome
chemical_list: D004791:Enzyme Inhibitors; C004717:diacetylmonoxime; D003931:Diacetyl
keywords: Cardiopulmonary resuscitation; Heart arrest; Ischaemic contracture; Myocardium