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Effects of Polyethylene Glycol-20k on Postresuscitation Myocardial and Cerebral Function in a Rat Model of Cardiopulmonary Resuscitation

Yang, Jin, MD, PhD1,2; Xiao, Yan, MD, PhD1,3; Quan, Eugenie Y., BA1; Hu, Zhangle, MD1; Guo, Qinyue, MD1; Miao, Changqing, MD1; Bradley, Jennifer L., MS1; Peberdy, Mary A., MD1,4; Ornato, Joseph P., MD1,5; Mangino, Martin J., PhD5,6,7; Tang, Wanchun, MD1,5,8

doi: 10.1097/CCM.0000000000003415
Online Laboratory Investigations

Objectives: Polyethylene glycol-20k is a hybrid cell impermeant that reduces ischemia injury and improves microcirculatory flow during and following low flow states through nonenergy-dependent water transfer in the microcirculation. We investigated the effects of polyethylene glycol-20k on postresuscitation microcirculation, myocardial and cerebral function, and duration of survival in a rat model of cardiopulmonary resuscitation.

Design: Ventricular fibrillation was induced in 20 male Sprague Dawley rats and untreated for 6 minutes. Animals were randomized into two groups (n = 10 for each group): polyethylene glycol-20k and control. Polyethylene glycol-20k (10% solution in saline, 10% estimated blood volume) and vehicle (saline) were administered at the beginning of cardiopulmonary resuscitation by continuous IV infusion. Resuscitation was attempted after 8 minutes of cardiopulmonary resuscitation.

Setting: University-Affiliated Research Laboratory.

Subjects: Sprague Dawley Rats.

Interventions: Polyethylene glycol-20k.

Measurements and Main Results: Buccal microcirculation was measured at baseline, 1, 3, and 6 hours after return of spontaneous circulation using a side-stream dark-field imaging device. Myocardial function was measured by echocardiography at baseline and every hour postresuscitation for 6 hours. The animals were then returned to their cage and observed for an additional 72 hours. Neurologic Deficit Scores were recorded at 24, 48, and 72 hours after resuscitation. Postresuscitation ejection fraction, cardiac output, and myocardial performance index were significantly improved in animals treated with polyethylene glycol-20k (p < 0.05). Perfused buccal vessel density and microcirculatory flow index values were significantly higher at all time points in the polyethylene glycol-20k group compared with the control group. Postresuscitation cerebral function and survival rate were also significantly improved in animals that received polyethylene glycol-20k.

Conclusions: Administration of polyethylene glycol-20k following cardiopulmonary resuscitation improves postresuscitation myocardial and cerebral function, buccal microcirculation, and survival in a rat model of cardiopulmonary resuscitation.

1Weil Institute of Emergency and Critical Care Research, Virginia Commonwealth University, Richmond, VA.

2Department of Respiratory Medicine, The second hospital of Anhui Medical University, Hefei, China.

3Department of Emergency Medicine, NO.2 Affiliated Hospital of Soochow University, Soochow, China.

4Departments of Internal Medicine and Emergency Medicine, Virginia Commonwealth University Health System, Richmond, VA.

5Department of Emergency Medicine, Virginia Commonwealth University Health System, Richmond, VA.

6Department of Surgery, Virginia Commonwealth University Health System, Richmond, VA.

7Department of Physiology and Biophysics, Virginia Commonwealth University, Richmond, VA.

8Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Drs. Yang and Xiao contributed equally to this work.

All work was performed at the Weil Institute of Emergency and Critical Care Research at Virginia Commonwealth University.

Supported, in part, by the project of Leading Talents in Pearl River Talent Plan of Guangdong Province, China (Number 81000-42020004), and by the Weil Family Foundation, California.

The authors have disclosed that they do not have any potential conflicts of interest.

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