Abstract 12447: Early Coronary Reperfusion Improves Cerebral and Systemic Hemodynamics After Ischemic Refractory Cardiac Arrest and Extracorporeal Resuscitation in Pigs
Bibliographic record
Abstract
Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) is widely proposed for the treatment of refractory cardiac arrest. It should be associated to etiologic determination, especially if acute coronary artery occlusion is suspected. However, prioritization of care remains unclear in this situation. Hypothesis: Our goal was to determine whether reperfusion should be instituted as soon as possible during ischemic refractory cardiac arrest treated by extracorporeal cardiopulmonary resuscitation (ECPR) in pigs. Methods: Pigs were instrumented and submitted to coronary artery occlusion prior to ventricular fibrillation. After 5 min of untreated cardiac arrest, life support was started using external chest compression (ECC) during 15 min followed by ECPR during 240 min, respectively. Animals randomly underwent either early or late coronary reperfusion after 20 or 120 min of ECPR, respectively. Return of spontaneous circulation (ROSC) was determined as organized ECG rhythm with systolic blood pressure above 80 mmHg. Results: Hemodynamic parameters were not different between groups at baseline or during ECC. Since the onset of ECPR, carotid blood flow was improved by ≈70% vs ECC in both groups. No animal (0/7) elicited ROSC after late reperfusion vs 4/7 after early reperfusion (p<0.05). Hemodynamic parameters, such as mean arterial pressure and carotid blood flow, were improved in early vs late reperfusion groups (Figure), along with infarct size decrease (71±4 vs 84±2 % of the risk zone, respectively; p<0.05). Conclusions: Early reperfusion improved hemodynamic status and increased ROSC chances after ischemic refractory cardiac arrest treated by ECPR. This supports the need of rapid reperfusion in this situation. Figure: Carotid blood flow after extracorporeal cardiopulmonary resuscitation (ECPR) and successful defibrillation (*, p<0.05 between groups; comparisons were only made at the end of the follow-up).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".