Femoral Vessel Occlusion Enhances Cardiac and Cerebral Perfusion in a Porcine Model of Cardiac Arrest
Background Closed chest compressions during cardiopulmonary resuscitation (CPR) mechanically circulate blood to the organs during cardiac arrest, yet cardiac arrest remains among the most fatal diseases, with a mortality rate that exceeds 85% to 90% globally. Novel methodologies to improve organ per...
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Wiley
2025-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.037413 |
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| author | Joshua Y. Kim Benjamin Usry Maren L. Downing Samuel W. Seigler Heather Holman Jennie H. Kwon Kristi Helke Rupak Mukherjee Jeffrey A. Jones Kristen M. Quinn |
| author_facet | Joshua Y. Kim Benjamin Usry Maren L. Downing Samuel W. Seigler Heather Holman Jennie H. Kwon Kristi Helke Rupak Mukherjee Jeffrey A. Jones Kristen M. Quinn |
| author_sort | Joshua Y. Kim |
| collection | DOAJ |
| description | Background Closed chest compressions during cardiopulmonary resuscitation (CPR) mechanically circulate blood to the organs during cardiac arrest, yet cardiac arrest remains among the most fatal diseases, with a mortality rate that exceeds 85% to 90% globally. Novel methodologies to improve organ perfusion, particularly in resource‐restricted settings, are overdue. This study evaluated the efficacy of external femoral vessel occlusion (FVO) during CPR in a large mammal model. Methods Thirteen adult Yorkshire pigs were instrumented with vascular and electrophysiologic monitoring lines. Hemodynamic measures and cardiac and cerebral perfusion in the pre‐ and postarrest conditions were quantified via fluorescent microspheres infused into the circulation. Control (n=7) animals underwent routine CPR, whereas experimental (n=6) animals received CPR and FVO via external compression to the femoral vessels during the entirety of the 30‐minute resuscitative phase. The primary outcome was mean arterial pressure, and secondary outcomes included cerebral and cardiac perfusion. Results During native heart function, external FVO demonstrated a significant increase in mean arterial pressure (73±3 versus 62±2 mm Hg, P<0.001). During cardiac arrest, animals undergoing CPR with FVO had a significantly higher mean arterial pressure compared with CPR alone (49±9 versus 32±3 mm Hg, P<0.001). CPR with FVO significantly increased cardiac (181 versus 80 mean fluorescence intensity, P=0.014) and cerebral perfusion (119 versus 27 mean fluorescence intensity, P<0.001). Conclusions CPR with FVO significantly increased mean arterial pressure, cardiac perfusion, and cerebral perfusion over CPR alone. These findings suggest FVO may represent a novel adjunctive strategy and therapeutic opportunity to enhance cerebral and cardiac perfusion, thereby decreasing cardiac arrest morbidity and mortality. |
| format | Article |
| id | doaj-art-ac2faa524d5f4b53b91f5d4a97b886a3 |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-ac2faa524d5f4b53b91f5d4a97b886a32025-08-20T03:58:49ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-07-01141310.1161/JAHA.124.037413Femoral Vessel Occlusion Enhances Cardiac and Cerebral Perfusion in a Porcine Model of Cardiac ArrestJoshua Y. Kim0Benjamin Usry1Maren L. Downing2Samuel W. Seigler3Heather Holman4Jennie H. Kwon5Kristi Helke6Rupak Mukherjee7Jeffrey A. Jones8Kristen M. Quinn9College of Medicine Medical University of South Carolina Charleston SC USACollege of Medicine Medical University of South Carolina Charleston SC USASchool of Osteopathic Medicine Campbell University Lillington NC USACollege of Medicine Medical University of South Carolina Charleston SC USACollege of Medicine Medical University of South Carolina Charleston SC USADepartment of Surgery Medical University of South Carolina Charleston SC USADepartment of Comparative Medicine Medical University of South Carolina Charleston SC USADivision of Cardiothoracic Surgery Medical University of South Carolina Charleston SC USADivision of Cardiothoracic Surgery Medical University of South Carolina Charleston SC USADepartment of Surgery Medical University of South Carolina Charleston SC USABackground Closed chest compressions during cardiopulmonary resuscitation (CPR) mechanically circulate blood to the organs during cardiac arrest, yet cardiac arrest remains among the most fatal diseases, with a mortality rate that exceeds 85% to 90% globally. Novel methodologies to improve organ perfusion, particularly in resource‐restricted settings, are overdue. This study evaluated the efficacy of external femoral vessel occlusion (FVO) during CPR in a large mammal model. Methods Thirteen adult Yorkshire pigs were instrumented with vascular and electrophysiologic monitoring lines. Hemodynamic measures and cardiac and cerebral perfusion in the pre‐ and postarrest conditions were quantified via fluorescent microspheres infused into the circulation. Control (n=7) animals underwent routine CPR, whereas experimental (n=6) animals received CPR and FVO via external compression to the femoral vessels during the entirety of the 30‐minute resuscitative phase. The primary outcome was mean arterial pressure, and secondary outcomes included cerebral and cardiac perfusion. Results During native heart function, external FVO demonstrated a significant increase in mean arterial pressure (73±3 versus 62±2 mm Hg, P<0.001). During cardiac arrest, animals undergoing CPR with FVO had a significantly higher mean arterial pressure compared with CPR alone (49±9 versus 32±3 mm Hg, P<0.001). CPR with FVO significantly increased cardiac (181 versus 80 mean fluorescence intensity, P=0.014) and cerebral perfusion (119 versus 27 mean fluorescence intensity, P<0.001). Conclusions CPR with FVO significantly increased mean arterial pressure, cardiac perfusion, and cerebral perfusion over CPR alone. These findings suggest FVO may represent a novel adjunctive strategy and therapeutic opportunity to enhance cerebral and cardiac perfusion, thereby decreasing cardiac arrest morbidity and mortality.https://www.ahajournals.org/doi/10.1161/JAHA.124.037413cardiac arrestcardiac perfusioncerebral perfusionCPR adjunctsvascular occlusion |
| spellingShingle | Joshua Y. Kim Benjamin Usry Maren L. Downing Samuel W. Seigler Heather Holman Jennie H. Kwon Kristi Helke Rupak Mukherjee Jeffrey A. Jones Kristen M. Quinn Femoral Vessel Occlusion Enhances Cardiac and Cerebral Perfusion in a Porcine Model of Cardiac Arrest Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiac arrest cardiac perfusion cerebral perfusion CPR adjuncts vascular occlusion |
| title | Femoral Vessel Occlusion Enhances Cardiac and Cerebral Perfusion in a Porcine Model of Cardiac Arrest |
| title_full | Femoral Vessel Occlusion Enhances Cardiac and Cerebral Perfusion in a Porcine Model of Cardiac Arrest |
| title_fullStr | Femoral Vessel Occlusion Enhances Cardiac and Cerebral Perfusion in a Porcine Model of Cardiac Arrest |
| title_full_unstemmed | Femoral Vessel Occlusion Enhances Cardiac and Cerebral Perfusion in a Porcine Model of Cardiac Arrest |
| title_short | Femoral Vessel Occlusion Enhances Cardiac and Cerebral Perfusion in a Porcine Model of Cardiac Arrest |
| title_sort | femoral vessel occlusion enhances cardiac and cerebral perfusion in a porcine model of cardiac arrest |
| topic | cardiac arrest cardiac perfusion cerebral perfusion CPR adjuncts vascular occlusion |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.037413 |
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