BackgroundSystematic reviews have disclosed a lack of clinically relevant cardiac arrest animal models. The aim of this study was to develop a cardiac arrest model in pigs encompassing relevant cardiac arrest characteristics and clinically relevant post‐resuscitation care.Methods and ResultsWe used 2 methods of myocardial infarction in conjunction with cardiac arrest. One group (n=7) had a continuous coronary occlusion, while another group (n=11) underwent balloon‐deflation during arrest and resuscitation with re‐inflation after return of spontaneous circulation. A sham group was included (n=6). All groups underwent 48 hours of intensive care including 24 hours of targeted temperature management. Pigs underwent invasive hemodynamic monitoring. Left ventricular function was assessed by pressure‐volume measurements. The proportion of pigs with return of spontaneous circulation was 43% in the continuous infarction group and 64% in the deflation‐reinflation group. In the continuous infarction group 29% survived the entire protocol while 55% survived in the deflation‐reinflation group. Both cardiac arrest groups needed vasopressor and inotropic support and pressure‐volume measurements showed cardiac dysfunction. During rewarming, systemic vascular resistance decreased in both cardiac arrest groups. Median [25%;75%] troponin‐I 48 hours after return of spontaneous circulation, was 88 973 ng/L [53 124;99 740] in the continuous infarction group, 19 661 ng/L [10 871;23 209] in the deflation‐reinflation group, and 1973 ng/L [1117;1995] in the sham group.ConclusionsThis article describes a cardiac arrest pig model with myocardial infarction, targeted temperature management, and clinically relevant post‐cardiac arrest care. We demonstrate 2 methods of inducing myocardial ischemia with cardiac arrest resulting in post‐cardiac arrest organ injury including cardiac dysfunction and cerebral injury.

中文翻译：

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2 种心肌梗塞方法诱导的 48 小时复苏后护理猪的心脏骤停：方法学描述

背景系统评价揭示了缺乏临床相关的心脏骤停动物模型。本研究的目的是开发一种猪心脏骤停模型，包括相关的心脏骤停特征和临床相关的复苏后护理。方法和结果我们使用了 2 种心肌梗死与心脏骤停相结合的方法。一组（n = 7）冠状动脉持续闭塞，而另一组（n = 11）在心脏骤停和复苏期间接受球囊放气，恢复自主循环后再次充气。包括一个假组（n = 6）。所有组都接受了 48 小时的重症监护，包括 24 小时的目标温度管理。猪接受有创血流动力学监测。通过压力-容积测量评估左心室功能。持续性梗死组和放气-再充气组恢复自主循环的猪比例分别为 43% 和 64%。在持续性梗死组中，29% 的人在整个方案中存活，而在通缩-再充气组中存活率为 55%。两个心脏骤停组都需要血管加压药和正性肌力支持，压力-容积测量显示心脏功能障碍。在复温期间，两个心脏骤停组的全身血管阻力均下降。在自主循环恢复后 48 小时，中位 [25%;75%] 肌钙蛋白-I 为 88 973 ng/L [53 124;99 740]，在持续梗死组中为 19 661 ng/L [10 871;23 209]在通货紧缩-再充气组中，1973 ng/L [1117;1995] 在假手术组中。有针对性的温度管理和临床相关的心脏骤停后护理。我们展示了两种诱导心肌缺血并导致心脏骤停后器官损伤的方法，包括心脏功能障碍和脑损伤。