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Sodium nitroprusside and mechanical CPR adjuncts for cardio-cerebral resuscitatio

硝普钠和机械心肺复苏辅助剂用于心脑复苏

基本信息

批准号：
8472362
负责人：
Demetris Yannopoulos
金额：
$ 48.18万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-07-25 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8472362
关键词：
Animal Model Applications Grants Blood Blood Circulation Blood flow Brain Cardiac Cardiac Output Cardiopulmonary Resuscitation Cerebral Ischemia Cerebrum Cessation of life Chest Clinical Trials Combined Modality Therapy Coronary Occlusions Cutaneous Data Development Devices Dilator Disodium Salt Nitroprusside Dose Electric Countershock Etiology Family suidae Goals Hand Heart Heart Arrest Heating Hospitals Hour Human Manuals Mechanics Methodology Methods Modeling Nervous System Physiology Neurologic Neurological outcome Organ Outcome Patients Perfusion Pharmaceutical Preparations Research Resuscitation Secondary to Surface Survival Rate Survivors Temperature Testing Therapeutic Translating Translations United States Vascular resistance Vasodilation Vasodilator Agents Ventricular Fibrillation base clinical effect improved innovation natural hypothermia novel pressure prevent protective effect vasoconstriction

项目摘要

DESCRIPTION (provided by applicant): Although almost 400,000 patients suffer cardiac arrest each year in the United States, average survival rates following Cardiopulmonary Resuscitation (CPR) have averaged <5% for the last 5 decades. Regrettably, manual standard CPR is inherently inefficient. Recent efforts have been shifted to reduce the ischemic damage to the brain and heart by increasing circulation with mechanical adjuncts and post arrest therapeutic hypothermia (TH). A method which promotes normalization of vital organ blood flow and simultaneously allows for intra-CPR TH could have the greatest impact on neurologically intact survival in cardiac arrest since the first description of chest compressions 50 years ago. In our grant proposal we describe the first favorable results and suggest research that needs to be performed on a new method of CPR with the potential to be used in all patients with cardiac arrest and maintain heart and brain viability for prolonged periods regardless of the presenting rhythm. We hypothesize that by using a combination of sodium nitroprusside (SNP), a potent vasodilator, and mechanical CPR adjuncts we can effectively normalize CPR-generated blood flow to the heart and brain. We further hypothesize that the pharmacologically induced cutaneous vasodilatation, combined with high forward blood flow, will facilitate intra- CPR heat exchange and TH. Our pilot data indicate that an achievable goal of this proposal is to conclusively show that elimination of thoracic and cerebral vasoconstriction with a potent vasodilator combined with non- invasive mechanical adjuncts that promote cardiac output and increase sub-diaphragmatic vascular resistance, will normalize and maintain vital organ perfusion during CPR. The pharmacological cutaneous vasodilatation will expedite heat exchange with surface cooling so that clinically valuable TH can be achieved before return to spontaneous circulation. Our proposed research will: 1.) identify the optimal combination of mechanical adjuncts and the optimal dose of sodium nitroprusside (SNP) to optimize flow and survival after cardiac arrest, 2.) demonstrate that SNP CPR offers similar benefits in different cardiac arrest models, and 3.) demonstrate that SNP CPR can provide immediate and effective intra-CPR therapeutic hypothermia.

描述（由申请人提供）：