Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2015
Milrinone and esmolol decrease cardiac damage after resuscitation from prolonged cardiac arrest.
Long-term survival after cardiac arrest (CA) due to shock-refractory ventricular fibrillation (VF) is low. Clearly, there is a need for new pharmacological interventions in the setting of cardiopulmonary resuscitation (CPR) to improve outcome. Here, hemodynamic parameters and cardiac damage are compared between the treatment group (milrinone, esmolol and vasopressin) and controls (vasopressin only) during resuscitation from prolonged CA in piglets. ⋯ The combination of milrinone, esmolol and vasopressin decreased cardiac injury compared with vasopressin alone.
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Acta Anaesthesiol Scand · Apr 2015
Veno-venous extracorporeal CO2 removal improves pulmonary hemodynamics in a porcine ARDS model.
Protective lung ventilation is recommended in patients with acute respiratory distress syndrome (ARDS) to minimize additional injuries to the lung. However, hypercapnic acidosis resulting from ventilation at lower tidal volume enhances pulmonary hypertension and might induce right ventricular (RV) failure. We investigated if extracorporeal veno-venous CO2 removal therapy could have beneficial effects on pulmonary circulation and RV function. ⋯ Veno-venous CO2 removal therapy enabled protective ventilation while maintaining normocarbia during ARDS. CO2 removal decreased pulmonary hypertension and improved RV function. This technique may be an effective lung- and RV-protective adjunct to mechanical ventilation.