Postresuscitation left ventricular systolic and diastolic dysfunction

Treatment with dobutamine

Karl B Kern, Ronald W. Hilwig, Robert A. Berg, Kyoo H. Rhee, Arthur B Sanders, Charles W Otto, Gordon A. Ewy

Research output: Contribution to journalArticle

145 Citations (Scopus)

Abstract

Background: Global left ventricular dysfunction after successful resuscitation is well documented and appears to bc a major contributing factor in limiting long-term survival after initial recovery from out-of- hospital sudden cardiac death. Treatment of such postresuscitation myocardial dysfunction has not been examined previously. Methods and Results: Systolic and diastolic parameters of left ventricular function were measured in 27 swine before and after successful resuscitation from prolonged ventricular fibrillation cardiac arrest. Dobutamine infusions (10 μg · kg-1 · min- 1 in 14 animals or 5 μg · kg-1 · min-1 in 5 animals) begun 15 minutes after resuscitation were compared with controls receiving no treatment (8 animals). The marked deterioration in systolic and diastolic left ventricular function seen in the control group after resuscitation was ameliorated in the dobutamine-treated animals. Left ventricular ejection fraction fell from a prearrest 58±3% to 25±3% at 5 hours after resuscitation in the control group but remained unchanged in the dobutamine (10 μg · kg-1 · min-1) group (52±1% prearrest and 55±3% at 5 hours after resuscitation. Measurement of the constant of isovolumic relaxation of the left ventricle (τ) demonstrated a similar benefit of the dobutamine infusion for overcoming postresuscitation diastolic dysfunction. The τ rose in the controls from 28±1 milliseconds (ms) prearrest to 41±3 ms at 5 hours after resuscitation whereas it remained constant in the dobutamine-treated animals (31±1 ms prearrest and 31±5 ms at 5 hours after resuscitation). Conclusions: Dobutamine begun within 15 minutes of successful resuscitation can successfully overcome the global systolic and diastolic left ventricular dysfunction resulting from prolonged cardiac arrest and cardiopulmonary resuscitation.

Original languageEnglish (US)
Pages (from-to)2610-2613
Number of pages4
JournalCirculation
Volume95
Issue number12
StatePublished - 1997

Fingerprint

Dobutamine
Resuscitation
Therapeutics
Left Ventricular Dysfunction
Heart Arrest
Left Ventricular Function
Control Groups
Sudden Cardiac Death
Cardiopulmonary Resuscitation
Ventricular Fibrillation
Stroke Volume
Heart Ventricles
Swine

Keywords

  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Fibrillation

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Postresuscitation left ventricular systolic and diastolic dysfunction : Treatment with dobutamine. / Kern, Karl B; Hilwig, Ronald W.; Berg, Robert A.; Rhee, Kyoo H.; Sanders, Arthur B; Otto, Charles W; Ewy, Gordon A.

In: Circulation, Vol. 95, No. 12, 1997, p. 2610-2613.

Research output: Contribution to journalArticle

Kern, Karl B ; Hilwig, Ronald W. ; Berg, Robert A. ; Rhee, Kyoo H. ; Sanders, Arthur B ; Otto, Charles W ; Ewy, Gordon A. / Postresuscitation left ventricular systolic and diastolic dysfunction : Treatment with dobutamine. In: Circulation. 1997 ; Vol. 95, No. 12. pp. 2610-2613.
@article{0b3b3b2845d94b5cb6c930efdcf97659,
title = "Postresuscitation left ventricular systolic and diastolic dysfunction: Treatment with dobutamine",
abstract = "Background: Global left ventricular dysfunction after successful resuscitation is well documented and appears to bc a major contributing factor in limiting long-term survival after initial recovery from out-of- hospital sudden cardiac death. Treatment of such postresuscitation myocardial dysfunction has not been examined previously. Methods and Results: Systolic and diastolic parameters of left ventricular function were measured in 27 swine before and after successful resuscitation from prolonged ventricular fibrillation cardiac arrest. Dobutamine infusions (10 μg · kg-1 · min- 1 in 14 animals or 5 μg · kg-1 · min-1 in 5 animals) begun 15 minutes after resuscitation were compared with controls receiving no treatment (8 animals). The marked deterioration in systolic and diastolic left ventricular function seen in the control group after resuscitation was ameliorated in the dobutamine-treated animals. Left ventricular ejection fraction fell from a prearrest 58±3{\%} to 25±3{\%} at 5 hours after resuscitation in the control group but remained unchanged in the dobutamine (10 μg · kg-1 · min-1) group (52±1{\%} prearrest and 55±3{\%} at 5 hours after resuscitation. Measurement of the constant of isovolumic relaxation of the left ventricle (τ) demonstrated a similar benefit of the dobutamine infusion for overcoming postresuscitation diastolic dysfunction. The τ rose in the controls from 28±1 milliseconds (ms) prearrest to 41±3 ms at 5 hours after resuscitation whereas it remained constant in the dobutamine-treated animals (31±1 ms prearrest and 31±5 ms at 5 hours after resuscitation). Conclusions: Dobutamine begun within 15 minutes of successful resuscitation can successfully overcome the global systolic and diastolic left ventricular dysfunction resulting from prolonged cardiac arrest and cardiopulmonary resuscitation.",
keywords = "Cardiac arrest, Cardiopulmonary resuscitation, Fibrillation",
author = "Kern, {Karl B} and Hilwig, {Ronald W.} and Berg, {Robert A.} and Rhee, {Kyoo H.} and Sanders, {Arthur B} and Otto, {Charles W} and Ewy, {Gordon A.}",
year = "1997",
language = "English (US)",
volume = "95",
pages = "2610--2613",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

TY - JOUR

T1 - Postresuscitation left ventricular systolic and diastolic dysfunction

T2 - Treatment with dobutamine

AU - Kern, Karl B

AU - Hilwig, Ronald W.

AU - Berg, Robert A.

AU - Rhee, Kyoo H.

AU - Sanders, Arthur B

AU - Otto, Charles W

AU - Ewy, Gordon A.

PY - 1997

Y1 - 1997

N2 - Background: Global left ventricular dysfunction after successful resuscitation is well documented and appears to bc a major contributing factor in limiting long-term survival after initial recovery from out-of- hospital sudden cardiac death. Treatment of such postresuscitation myocardial dysfunction has not been examined previously. Methods and Results: Systolic and diastolic parameters of left ventricular function were measured in 27 swine before and after successful resuscitation from prolonged ventricular fibrillation cardiac arrest. Dobutamine infusions (10 μg · kg-1 · min- 1 in 14 animals or 5 μg · kg-1 · min-1 in 5 animals) begun 15 minutes after resuscitation were compared with controls receiving no treatment (8 animals). The marked deterioration in systolic and diastolic left ventricular function seen in the control group after resuscitation was ameliorated in the dobutamine-treated animals. Left ventricular ejection fraction fell from a prearrest 58±3% to 25±3% at 5 hours after resuscitation in the control group but remained unchanged in the dobutamine (10 μg · kg-1 · min-1) group (52±1% prearrest and 55±3% at 5 hours after resuscitation. Measurement of the constant of isovolumic relaxation of the left ventricle (τ) demonstrated a similar benefit of the dobutamine infusion for overcoming postresuscitation diastolic dysfunction. The τ rose in the controls from 28±1 milliseconds (ms) prearrest to 41±3 ms at 5 hours after resuscitation whereas it remained constant in the dobutamine-treated animals (31±1 ms prearrest and 31±5 ms at 5 hours after resuscitation). Conclusions: Dobutamine begun within 15 minutes of successful resuscitation can successfully overcome the global systolic and diastolic left ventricular dysfunction resulting from prolonged cardiac arrest and cardiopulmonary resuscitation.

AB - Background: Global left ventricular dysfunction after successful resuscitation is well documented and appears to bc a major contributing factor in limiting long-term survival after initial recovery from out-of- hospital sudden cardiac death. Treatment of such postresuscitation myocardial dysfunction has not been examined previously. Methods and Results: Systolic and diastolic parameters of left ventricular function were measured in 27 swine before and after successful resuscitation from prolonged ventricular fibrillation cardiac arrest. Dobutamine infusions (10 μg · kg-1 · min- 1 in 14 animals or 5 μg · kg-1 · min-1 in 5 animals) begun 15 minutes after resuscitation were compared with controls receiving no treatment (8 animals). The marked deterioration in systolic and diastolic left ventricular function seen in the control group after resuscitation was ameliorated in the dobutamine-treated animals. Left ventricular ejection fraction fell from a prearrest 58±3% to 25±3% at 5 hours after resuscitation in the control group but remained unchanged in the dobutamine (10 μg · kg-1 · min-1) group (52±1% prearrest and 55±3% at 5 hours after resuscitation. Measurement of the constant of isovolumic relaxation of the left ventricle (τ) demonstrated a similar benefit of the dobutamine infusion for overcoming postresuscitation diastolic dysfunction. The τ rose in the controls from 28±1 milliseconds (ms) prearrest to 41±3 ms at 5 hours after resuscitation whereas it remained constant in the dobutamine-treated animals (31±1 ms prearrest and 31±5 ms at 5 hours after resuscitation). Conclusions: Dobutamine begun within 15 minutes of successful resuscitation can successfully overcome the global systolic and diastolic left ventricular dysfunction resulting from prolonged cardiac arrest and cardiopulmonary resuscitation.

KW - Cardiac arrest

KW - Cardiopulmonary resuscitation

KW - Fibrillation

UR - http://www.scopus.com/inward/record.url?scp=0031009256&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031009256&partnerID=8YFLogxK

M3 - Article

VL - 95

SP - 2610

EP - 2613

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 12

ER -