Ultra-low-tidal-volume ventilation during cardiopulmonary resuscitation in a pig model

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The proposed project deals with the evaluation of a newly established ventilation method (ultra-low-tidal-volume ventilation, ULTVV) during cardiopulmonary resuscitation in a porcine model. Following a successful pilot study showing neuro- and lung-protective effects of ULTVV during resuscitation and after return of spontaneous circulation (ROSC) and generally increased ROSC-rates after induced ventricular fibrillation compared to standard ventilation (IPPV), the presented trial aims to investigate whether or not the previously perceived beneficial influences persist in a prolonged, clinically more accurate setting with longer arrest and monitoring periods.More precisely, two different arrest periods (5 vs. 10 minutes) will be compared between two ventilation strategies (ULTVV vs. IPPV). Animals that reach ROSC after a predefined, guideline-based resuscitaion cycle (~25 minutes) -regardless to which group they belong - will be monitored and treated for 24 hours. During this period blood samples are taken regularly, extended cardiovascular measurements are monitored and saved constantly and pulmonary function is assessed in detail. At the end of the monitoring period, lungs, brain and kidneys are harvested, prepared for histopathologic and molecularbiologic testing and are screened for potential mechanical or hypoxic tissue damages.This experiment aims at confirming previously obtained results that ventilation with highly decreased tidal volumes during resuscitation can be linked to increased ROSC rates as well as lower mechanically induced lung damage and ameliorated pulmonary function. Additionally, the long term trials are designed to support signs of decreased neuroinflammation, which were prominent after 8 h but might not persist over a longer period. The added arrest time modification to longer values provides a clinically more realistic setting and combined with the prolonged monitoring period might help to elucidate, if and in what fashion the positive effects of ULTVV persist or if they exhaust with longer resuscitation cycles. The expected results and insights are planned to be the basis of possible clinical studies for the new ventilation strategy and might eventually create a potential new therapy for patients.