8(3)1-11-xml.enl0Rousseau, Mathieu CJodlowski, GrzegorzPrice, ColinDvir, MayNelson, JackWalker, Patrick FMorrison, Jonathan JCritical Care InnovationsCritical Care Innovations1-1183202510.32114/CCI.2025.8.3.1.11https://doi.org/10.32114/CCI.2025.8.3.1.11INTRODUCTION: 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.