Extracorporeal Cardiopulmonary Resuscitation Guided by End-Tidal Carbon Dioxide-a Porcine Model

Extracorporeal membrane cardiopulmonary resuscitation (ECPR) during cardiopulmonary resuscitation (CPR) for selected cases and end-tidal carbon dioxide (ETCO2) could be used to guide initiation of ECPR. Ventricular fibrillation was induced in 12 pigs and CPR was performed until ETCO2 fell below 10 mmHg; then, ECPR was performed. Animals were divided into group short (G(Short)) and group long (G(Long)), according to time of CPR. Carotid blood flow was higher (p = 0.02) and mean arterial blood pressure lower in G(Long) during CPR (p < 0.05). B-Lactate was lower and pH higher in G(Short) (p < 0.01). In microdialysis lactate-pyruvate ratio, glycerol and glutamate increased in both groups during CPR, but considerably in G(Long) (p < 0.01). No difference could be seen in histopathology of the brain or kidney post-ECPR. No apparent histological differences of tissue damage in brains or levels of S100B in plasma were detected between groups. This might suggest that ETCO2 could be used as a marker for brain injury following ECPR.