The Influence of Ultra-Low Tidal Volume Ventilation During Cardiopulmonary Resuscitation on Renal and Hepatic End-Organ Damage in a Porcine Model

Overview

Journal Biomedicines

Specialty Biomedical Engineering

Date 2023 Mar 29

PMID 36979878

Authors

Katja Mohnke

Victoria Buschmann

Thomas Baller

Julian Riedel

Miriam Renz

Rene Rissel

Alexander Ziebart

Erik K Hartmann

Robert Ruemmler

Affiliations

Soon will be listed here.

Abstract

The optimal ventilation strategy during cardiopulmonary resuscitation (CPR) has eluded scientists for years. This porcine study aims to validate the hypothesis that ultra-low tidal volume ventilation (tidal volume 2-3 mL kg; ULTVV) minimizes renal and hepatic end-organ damage when compared to standard intermittent positive pressure ventilation (tidal volume 8-10 mL kg; IPPV) during CPR. After induced ventricular fibrillation, the animals were ventilated using an established CPR protocol. Upon return of spontaneous circulation (ROSC), the follow-up was 20 h. After sacrifice, kidney and liver samples were harvested and analyzed histopathologically using an Endothelial, Glomerular, Tubular, and Interstitial (EGTI) scoring system for the kidney and a newly developed scoring system for the liver. Of 69 animals, 5 in the IPPV group and 6 in the ULTVV group achieved sustained ROSC and were enlisted, while 4 served as the sham group. Creatinine clearance was significantly lower in the IPPV-group than in the sham group ( < 0.001). The total EGTI score was significantly higher for ULTVV than for the sham group ( = 0.038). Aminotransferase levels and liver score showed no significant difference between the intervention groups. ULTVV may be advantageous when compared to standard ventilation during CPR in the short-term ROSC follow-up period.

Citing Articles

Ultra-low tidal volume ventilation during cardiopulmonary resuscitation shows no mitigating effect on pulmonary end-organ damage compared to standard ventilation: insights from a porcine model.

Mohnke K, Conzelmann P, Renz M, Riedel J, Rissel R, Urmann A Intensive Care Med Exp. 2023; 11(1):81.

PMID: 38006467 PMC: 10676323. DOI: 10.1186/s40635-023-00568-6.

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