2025; 8(3): 1-11
DOI: 10.32114/CCI.2025.8.3.1.11
Published online: 2025-09-30 (first online 2025-08-15)
Practical application of pressure-volume loop analysis in a swine model of medical cardiac arrest.
Mathieu C Rousseau [1]
,
Grzegorz Jodlowski [2] ,
Colin Price [2] ,
May Dvir [2] ,Jack Nelson [2]
,
Patrick F Walker [3] ,
Jonathan J Morrison [2] .
[1] Department of Thoracic Surgery, McGill University Health Centre, Montreal, Canada
[2] Department of Endovascular and Vascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
[3] Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
Abstract:
Abstract [EN] -
INTRODUCTION: Cardiac arrest (CA) is the sudden cessation of cardiac activity, leading to hemodynamic collapse and high mortality. Advanced cardiac life support (ACLS) standardizes resuscitation, but the post-return of spontaneous circulation (ROSC) period remains turbulent and poorly understood. Pressure-volume loop (PVL) analysis offers insight into load-independent cardiac biomechanics. The aim of this study is to explore the feasibility PVL analysis in a swine model of CA. MATERIALS AND METHODS: This swine study utilized a ventricular fibrillation (VF) cardiac arrest model in combination with PVL analysis. Swine underwent anesthesia and instrumentation. Ventricular fibrillation was induced using an electrophysiology catheter. Subjects were divided into 3- and 6- minutes of CA before commencement of ACLS for 30 mins. If ROSC was obtained, animals underwent a 3-hr critical care period. Cardiac indices were compared between baseline and end-of-study values. RESULTS: Eight Yorkshire swine were studied, with VF successfully induced and PVL data collected. All animals in the 3- minute ACLS group achieved ROSC compared to one in the 6-minute group. Post-ROSC metabolic changes included acidemia, elevated lactate and potassium, partially resolving by study end. Right ventricle PVL data was unreliable, while left ventricle PVL was reliable in 3 of 5 ROSC animals. Preload-recruitable stroke work proved most trustworthy, showing a hyperdynamic circulation post-resuscitation. CONCLUSIONS: This study demonstrates that PVL analysis can be applied to a post-ROSC swine model of CA, although there are technical limits. Unsurprisingly, warm ischemic time predicted ROSC; however, PVL analysis provided insights into load-independent parameters and has the potential to guide future therapeutic targets for post-ROSC intervention.
Streszczenie [PL] -
WSTĘP: Zatrzymanie krążenia (NZK) to nagłe ustanie czynności serca, prowadzące do zapaści hemodynamicznej i wysokiej śmiertelności. Zaawansowane zabiegi resuscytacyjne (ACLS) standaryzują resuscytację, ale okres po powrocie spontanicznego krążenia (ROSC) pozostaje burzliwy i słabo poznany. Analiza pętli ciśnieniowo-objętościowej (PVL) pozwala na wgląd w biomechanikę serca niezależną od obciążenia. Celem niniejszego badania jest zbadanie wykonalności analizy PVL w świńskim modelu NZK. MATERIAŁY I METODY: W badaniu na świniach wykorzystano model zatrzymania krążenia w migotaniu komór (VF) w połączeniu z analizą PVL. Świnie poddano znieczuleniu i instrumentacji. Migotanie komór wywołano za pomocą cewnika elektrofizjologicznego. Pacjentów podzielono na 3- i 6-minutowe CA przed rozpoczęciem ACLS trwającego 30 minut. W przypadku uzyskania ROSC zwierzęta poddawano 3-godzinnemu okresowi intensywnej terapii. Porównano wskaźniki sercowe między wartościami wyjściowymi i końcowymi badania. WYNIKI: Badano osiem świń rasy Yorkshire, u których skutecznie wywołano migotanie komór i zebrano dane dotyczące PVL. Wszystkie zwierzęta w grupie 3-minutowego ACLS osiągnęły ROSC w porównaniu do jednego w grupie 6-minutowej. Zmiany metaboliczne po ROSC obejmowały kwasicę, podwyższony poziom mleczanu i potasu, częściowo ustępujące do końca badania. Dane dotyczące PVL prawej komory były niewiarygodne, podczas gdy dane dotyczące PVL lewej komory były wiarygodne u 3 z 5 zwierząt z ROSC. Praca nad udarem z możliwością rekrutacji obciążenia wstępnego okazała się najbardziej wiarygodna, pokazując hiperdynamiczne krążenie po resuscytacji. WNIOSKI: Badanie to pokazuje, że analizę PVL można zastosować do świńskiego modelu CA po ROSC, chociaż istnieją ograniczenia techniczne. Nie jest zaskakujące, że ciepły czas niedokrwienia przewidywał ROSC; Jednakże analiza PVL dostarczyła spostrzeżeń na temat parametrów niezależnych od obciążenia i może potencjalnie pomóc w ustaleniu przyszłych celów terapeutycznych dla interwencji po ROSC.
Citation:
VANCOUVER FORMAT
Rousseau MC, Jodlowski G, Price C, Dvir M, Nelson J, Walker PF, et al.. Practical application of pressure-volume loop analysis in a swine model of medical cardiac arrest.
Crit. Care Innov. 2025; 8(3): 1-11.
DOI: 10.32114/CCI.2025.8.3.1.11
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