• Anesthesia and analgesia · Apr 2009

    Comparative Study

    Intralipid infusion diminishes return of spontaneous circulation after hypoxic cardiac arrest in rabbits.

    • Martyn Harvey, Grant Cave, and Alex Kazemi.
    • Department of Emergency Medicine, Waikato Hospital, Pembroke Street, Hamilton, New Zealand. harveym@waikatodhb.govt.nz
    • Anesth. Analg. 2009 Apr 1;108(4):1163-8.

    BackgroundInfusion of lipid emulsion has been shown to reverse lipophilic drug-induced cardiovascular collapse in laboratory models and humans. The effect of high dose lipid in nondrug-induced cardiac arrest is, however, uncertain. In a rabbit model of asphyxial pulseless electrical activity (PEA) we compared lipid augmented with standard advanced cardiac life support (ACLS) resuscitation.MethodAdult New Zealand White rabbits underwent hypoxic PEA via tracheal clamping. After 2 min of cardiac arrest, basic life support cardiopulmonary resuscitation was commenced and 3 mL/kg 20% Intralipid or 3 mL/kg 0.9% saline solution infused. Adrenaline (100 microg/kg) was administered at 4 and 5 min. Return of spontaneous circulation (ROSC), hemodynamic metrics, and survival to 50 min were recorded.ResultsSeven of 11 saline-treated rabbits developed ROSC versus 1 of 12 Intralipid-treated animals; P = 0.009. No significant difference in survival to 50 min was observed (3/11 saline vs 0/12 Intralipid; P = 0.211).ConclusionIn this model of hypoxia-induced PEA, standard ACLS resulted in greater coronary perfusion pressure and increased ROSC compared with ACLS plus lipid infusion. Lipid emulsion may be contraindicated in cardiac arrest complicated by significant hypoxia.

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