PMID- 28131602 OWN - NLM STAT- MEDLINE DCOM- 20170803 LR - 20170803 IS - 1532-8171 (Electronic) IS - 0735-6757 (Linking) VI - 35 IP - 6 DP - 2017 Jun TI - Correlation of Impedance Threshold Device use during cardiopulmonary resuscitation with post-cardiac arrest Acute Kidney Injury. PG - 846-854 LID - S0735-6757(17)30057-8 [pii] LID - 10.1016/j.ajem.2017.01.040 [doi] AB - PURPOSE: To assess whether use of Impedance Threshold Device (ITD) during cardiopulmonary resuscitation (CPR) reduces the degree of post-cardiac arrest Acute Kidney Injury (AKI), as a result of improved hemodynamics, in a porcine model of ventricular fibrillation (VF) cardiac arrest. METHODS: After 8 min of untreated cardiac arrest, the animals were resuscitated either with active compression-decompression (ACD) CPR plus a sham ITD (control group, n=8) or with ACD-CPR plus an active ITD (ITD group, n=8). Adrenaline was administered every 4 min and electrical defibrillation was attempted every 2 min until return of spontaneous circulation (ROSC) or asystole. After ROSC the animals were monitored for 6 h under general anesthesia and then returned to their cages for a 48 h observation, before euthanasia. Two novel biomarkers, Neutrophil Gelatinase-Associated Lipocalin (NGAL) in plasma and Interleukin-18 (IL-18) in urine, were measured at 2 h, 4 h, 6 h, 24 h and 48 h post-ROSC, in order to assess the degree of AKI. RESULTS: ROSC was observed in 7 (87.5%) animals treated with the sham valve and 8 (100%) animals treated with the active valve (P=NS). However, more than twice as many animals survived at 48 h in the ITD group (n=8, 100%) compared to the control group (n=3, 37.5%). Urine IL-18 and plasma NGAL levels were augmented post-ROSC in both groups, but they were significantly higher in the control group compared with the ITD group, at all measured time points. CONCLUSION: Use of ITD during ACD-CPR improved hemodynamic parameters, increased 48 h survival and decreased the degree of post-cardiac arrest AKI in the resuscitated animals. CI - Copyright (c) 2017 Elsevier Inc. All rights reserved. FAU - Niforopoulou, Panagiota AU - Niforopoulou P AD - National and Kapodistrian University of Athens, Medical School, 3A Parou st, Melissia, Athens 15127, Greece. Electronic address: panifor@gmail.com. FAU - Iacovidou, Nicoletta AU - Iacovidou N AD - National and Kapodistrian University of Athens, Medical School, 3 Pavlou Mela st, Athens 16233, Greece. Electronic address: niciac58@gmail.com. FAU - Lelovas, Pavlos AU - Lelovas P AD - National and Kapodistrian University of Athens, Medical School, Laboratory of Research of the Musculoskeletal System, 10 Athinas st, Kifissia, Athens 14561, Greece. Electronic address: paulveterin@yahoo.com. FAU - Karlis, George AU - Karlis G AD - National and Kapodistrian University of Athens, Medical School, 45-47 Ypsilantou st, Athens 10676, Greece. Electronic address: georgekarlis@yahoo.com. FAU - Papalois, Alphapostolos AU - Papalois Alpha AD - Experimental-Research Centre, ELPEN Pharmaceutical Co. Inc., 95 Marathonos Ave, Pikermi, Athens 19009, Greece. Electronic address: apapalois@elpen.gr. FAU - Siakavellas, Spyros AU - Siakavellas S AD - National and Kapodistrian University of Athens, Medical School, Academic Department of Gastroenterology, Laikon General Hospital, 17 Aghiou Thoma st, Athens 11527, Greece. Electronic address: s.siakavellas@gmail.com. FAU - Spapis, Vasileios AU - Spapis V AD - Hippokrateion General Hospital of Athens, 114 Vassilissis Sofias Ave, Athens, 11527, Greece. Electronic address: vspapis@hotmail.com. FAU - Kaparos, George AU - Kaparos G AD - Aretaieion University Hospital, Biopathology Department, 76 Vassilissis Sofias Ave, Athens 11528, Greece. Electronic address: captenkap@yahoo.gr. FAU - Siafaka, Ioanna AU - Siafaka I AD - National and Kapodistrian University of Athens, Medical School, Aretaieion University Hospital, 76 Vassilissis Sofias Ave, Athens 11528, Greece. Electronic address: isiafaka@hotmail.com. FAU - Xanthos, Theodoros AU - Xanthos T AD - European University of Cyprus, School of Medicine, 6 Diogenis str, Engomi, Nicosia 1516, Cyprus. Electronic address: theodorosxanthos@yahoo.com. LA - eng PT - Journal Article DEP - 20170123 PL - United States TA - Am J Emerg Med JT - The American journal of emergency medicine JID - 8309942 RN - 0 (Biomarkers) RN - 0 (Interleukin-18) RN - 0 (Lipocalin-2) RN - YKH834O4BH (Epinephrine) SB - IM MH - Acute Kidney Injury/*complications MH - Animals MH - Biomarkers/urine MH - Cardiopulmonary Resuscitation/*instrumentation MH - Disease Models, Animal MH - *Electric Impedance MH - Epinephrine/therapeutic use MH - Female MH - Heart Arrest/*therapy MH - Hemodynamics MH - Interleukin-18/urine MH - Lipocalin-2/urine MH - Monitoring, Physiologic MH - Swine MH - Ventricular Fibrillation/*therapy OTO - NOTNLM OT - Acute Kidney Injury OT - Cardiopulmonary resuscitation OT - Impedance Threshold Device OT - Interleukin-18 OT - Neutrophil Gelatinase-Associated Lipocalin OT - Ventricular fibrillation EDAT- 2017/01/31 06:00 MHDA- 2017/08/05 06:00 CRDT- 2017/01/30 06:00 PHST- 2016/12/11 00:00 [received] PHST- 2017/01/16 00:00 [revised] PHST- 2017/01/21 00:00 [accepted] PHST- 2017/01/31 06:00 [pubmed] PHST- 2017/08/05 06:00 [medline] PHST- 2017/01/30 06:00 [entrez] AID - S0735-6757(17)30057-8 [pii] AID - 10.1016/j.ajem.2017.01.040 [doi] PST - ppublish SO - Am J Emerg Med. 2017 Jun;35(6):846-854. doi: 10.1016/j.ajem.2017.01.040. Epub 2017 Jan 23.