Sodium Nitroprusside–Enhanced Cardiopulmonary Resuscitation Improves Blood Flow by Pulmonary Vasodilation Leading to Higher Oxygen Requirements

Adrian Ripeckyj; Marinos Kosmopoulos; Kadambari Shekar; Claire Carlson; Rajat Kalra; Jennifer Rees; Tom P. Aufderheide; Jason A. Bartos; Demetris Yannopoulos

doi:10.1016/j.jacbts.2019.11.010

Sodium Nitroprusside–Enhanced Cardiopulmonary Resuscitation Improves Blood Flow by Pulmonary Vasodilation Leading to Higher Oxygen Requirements

Adrian Ripeckyj, Marinos Kosmopoulos, Kadambari Shekar, Claire Carlson, Rajat Kalra, Jennifer Rees, Tom P. Aufderheide, Jason A. Bartos, Demetris Yannopoulos

Medicine - Cardiology Division

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

Sodium nitroprusside–enhanced cardiopulmonary resuscitation has shown superior resuscitation rates and neurologic outcomes in large animal models supporting the need for a randomized human clinical trial. This study is the first to show nonselective pulmonary vasodilation as a potential mechanism for the hemodynamic benefits. The pulmonary shunting that is created requires increased oxygen treatment, but the overall improvement in blood flow increases minute oxygen delivery to tissues. In this context, hypoxemia is an important safety endpoint and a 100% oxygen ventilation strategy may be necessary for the first human clinical trial.

Original language	English (US)
Pages (from-to)	183-192
Number of pages	10
Journal	JACC: Basic to Translational Science
Volume	5
Issue number	2
DOIs	https://doi.org/10.1016/j.jacbts.2019.11.010
State	Published - Feb 2020

Bibliographical note

Funding Information:
This study was funded by an R01 research grant (R01HL108926) from the National Institutes of Health National Heart, Lung, and Blood Institute to Dr. Yannopoulos. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Publisher Copyright:
© 2020 The Authors

Keywords

cardiopulmonary resuscitation
coronary perfusion pressure
lactic acid
pulmonary vasodilation
sodium nitroprusside

Access

10.1016/j.jacbts.2019.11.010

OpenUrl availability

Full text

Cite this

Ripeckyj, A., Kosmopoulos, M., Shekar, K., Carlson, C., Kalra, R., Rees, J., Aufderheide, T. P., Bartos, J. A., & Yannopoulos, D. (2020). Sodium Nitroprusside–Enhanced Cardiopulmonary Resuscitation Improves Blood Flow by Pulmonary Vasodilation Leading to Higher Oxygen Requirements. JACC: Basic to Translational Science, 5(2), 183-192. https://doi.org/10.1016/j.jacbts.2019.11.010

Ripeckyj, A, Kosmopoulos, M, Shekar, K, Carlson, C, Kalra, R, Rees, J, Aufderheide, TP, Bartos, JA & Yannopoulos, D 2020, 'Sodium Nitroprusside–Enhanced Cardiopulmonary Resuscitation Improves Blood Flow by Pulmonary Vasodilation Leading to Higher Oxygen Requirements', JACC: Basic to Translational Science, vol. 5, no. 2, pp. 183-192. https://doi.org/10.1016/j.jacbts.2019.11.010

@article{35fad6f742e24a0e986aa721e38a81a5,

title = "Sodium Nitroprusside–Enhanced Cardiopulmonary Resuscitation Improves Blood Flow by Pulmonary Vasodilation Leading to Higher Oxygen Requirements",

abstract = "Sodium nitroprusside–enhanced cardiopulmonary resuscitation has shown superior resuscitation rates and neurologic outcomes in large animal models supporting the need for a randomized human clinical trial. This study is the first to show nonselective pulmonary vasodilation as a potential mechanism for the hemodynamic benefits. The pulmonary shunting that is created requires increased oxygen treatment, but the overall improvement in blood flow increases minute oxygen delivery to tissues. In this context, hypoxemia is an important safety endpoint and a 100% oxygen ventilation strategy may be necessary for the first human clinical trial.",

keywords = "cardiopulmonary resuscitation, coronary perfusion pressure, lactic acid, pulmonary vasodilation, sodium nitroprusside",

author = "Adrian Ripeckyj and Marinos Kosmopoulos and Kadambari Shekar and Claire Carlson and Rajat Kalra and Jennifer Rees and Aufderheide, {Tom P.} and Bartos, {Jason A.} and Demetris Yannopoulos",

note = "Funding Information: This study was funded by an R01 research grant (R01HL108926) from the National Institutes of Health National Heart, Lung, and Blood Institute to Dr. Yannopoulos. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: {\textcopyright} 2020 The Authors",

year = "2020",

month = feb,

doi = "10.1016/j.jacbts.2019.11.010",

language = "English (US)",

volume = "5",

pages = "183--192",

journal = "JACC: Basic to Translational Science",

issn = "2452-302X",

publisher = "Elsevier Inc.",

number = "2",

}

TY - JOUR

T1 - Sodium Nitroprusside–Enhanced Cardiopulmonary Resuscitation Improves Blood Flow by Pulmonary Vasodilation Leading to Higher Oxygen Requirements

AU - Ripeckyj, Adrian

AU - Kosmopoulos, Marinos

AU - Shekar, Kadambari

AU - Carlson, Claire

AU - Kalra, Rajat

AU - Rees, Jennifer

AU - Aufderheide, Tom P.

AU - Bartos, Jason A.

AU - Yannopoulos, Demetris

N1 - Funding Information: This study was funded by an R01 research grant (R01HL108926) from the National Institutes of Health National Heart, Lung, and Blood Institute to Dr. Yannopoulos. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: © 2020 The Authors

PY - 2020/2

Y1 - 2020/2

N2 - Sodium nitroprusside–enhanced cardiopulmonary resuscitation has shown superior resuscitation rates and neurologic outcomes in large animal models supporting the need for a randomized human clinical trial. This study is the first to show nonselective pulmonary vasodilation as a potential mechanism for the hemodynamic benefits. The pulmonary shunting that is created requires increased oxygen treatment, but the overall improvement in blood flow increases minute oxygen delivery to tissues. In this context, hypoxemia is an important safety endpoint and a 100% oxygen ventilation strategy may be necessary for the first human clinical trial.

AB - Sodium nitroprusside–enhanced cardiopulmonary resuscitation has shown superior resuscitation rates and neurologic outcomes in large animal models supporting the need for a randomized human clinical trial. This study is the first to show nonselective pulmonary vasodilation as a potential mechanism for the hemodynamic benefits. The pulmonary shunting that is created requires increased oxygen treatment, but the overall improvement in blood flow increases minute oxygen delivery to tissues. In this context, hypoxemia is an important safety endpoint and a 100% oxygen ventilation strategy may be necessary for the first human clinical trial.

KW - cardiopulmonary resuscitation

KW - coronary perfusion pressure

KW - lactic acid

KW - pulmonary vasodilation

KW - sodium nitroprusside

UR - http://www.scopus.com/inward/record.url?scp=85080072630&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85080072630&partnerID=8YFLogxK

U2 - 10.1016/j.jacbts.2019.11.010

DO - 10.1016/j.jacbts.2019.11.010

M3 - Article

C2 - 32140624

AN - SCOPUS:85080072630

SN - 2452-302X

VL - 5

SP - 183

EP - 192

JO - JACC: Basic to Translational Science

JF - JACC: Basic to Translational Science

IS - 2

ER -

Sodium Nitroprusside–Enhanced Cardiopulmonary Resuscitation Improves Blood Flow by Pulmonary Vasodilation Leading to Higher Oxygen Requirements

Abstract

Bibliographical note

Keywords

Access

OpenUrl availability

Other files and links

Fingerprint

Cite this