Experimental model of cardiovascular post-resuscitation syndrome - no effect of platelet activating factor antagonism

The cardiovascular instability seen in the reperfusion phase after resuscit ation from cardiac arrest may contribute to secondary brain injury. The aim of the present study was to characterise post-resuscitation cardiovascular instability in an experimental model of cardiac arrest and to test if card iovascular stability could be improved by pre-treatment with the platelet a ctivating factor (PAF) antagonist BN52021. Ten anaesthetised pigs received pre-treatment with BN52021 before induction of ventricular fibrillation (ar rest/BN52021 group), while ten animals received only the vehicle (arrest/ve hicle group). After a non-intervention interval of 9 min, resuscitation was attempted. Resuscitated animals were observed for 5 h and compared to a sh am arrear group of seven animals. The haemodynamic situation after resuscit ation was characterised by a low cardiac output that was inadequate in rela tion to the oxygen demand, as reflected by a low mixed venous oxygen satura tion. The arterial blood pressure was to some extent reduced and the fillin g pressures in both the right and left heart were increased, but urinary ou tput was not reduced. The severe haemodynamic compromise was not adequately reflected by standard monitoring variables such as arterial blood pressure and urinary output. Pre-treatment with BN52021 was unable to improve any a spect of short-term survival or haemodynamic stability. (C) 1998 Elsevier S cience Ireland Ltd. All rights reserved.