Publications by authors named "Petra Krupickova"
Background: In refractory cardiac arrest, extracorporeal cardiopulmonary resuscitation may increase the survival chance. However, in cases of unsuccessful treatment, extracorporeal cardiopulmonary resuscitation may additionally provide an important source of organ donors. Therefore, we hypothesized that implementing extracorporeal cardiopulmonary resuscitation service into a high-volume cardiac arrest center's routine would increases organ donors' availability.
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- - The study investigated how regional tissue oxygenation (rSO) relates to microcirculatory and systemic hemodynamic changes during cardiac arrest (CA) using a porcine model.
- - Researchers induced ventricular fibrillation in 24 pigs and monitored rSO, microcirculation, and blood flow before, during, and after CA, finding that brain oxygen levels rose during CPR while peripheral levels remained stable.
- - Results showed a moderate correlation between rSO and various microcirculatory/hemodynamic parameters, suggesting that brain rSO is a better indicator of CPR quality than peripheral rSO.
Article Synopsis
- Cardiac arrest is a major health issue in developed countries, and extracorporeal cardiopulmonary resuscitation (ECPR) can improve survival chances for those experiencing severe cardiac arrest.
- ECPR and subsequent care face challenges due to high death rates from multi-organ failure, often tied to issues in microcirculation.
- Advanced videomicroscopic technologies are emerging as useful tools for assessing and monitoring microcirculation in patients after cardiac arrest, which is critical for improving treatment outcomes.
The effect of pulsatile blood flow on microcirculation during extracorporeal cardiopulmonary resuscitation (ECPR) is not elucidated; therefore, we designed an observational study comparing sublingual microcirculation in patients with refractory cardiac arrest (CA) with spontaneously pulsatile or low/nonpulsatile blood flow after treatment with ECPR. Microcirculation was assessed with Sidestream Dark Field technology in 12 patients with CA who were treated with ECPR and 12 healthy control subjects. Microcirculatory images were analyzed offline in a blinded fashion, and consensual parameters were determined for the vessels ≤20 μm.
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- Current research shows that microcirculatory disorders during cardiac arrest and CPR are linked to patient outcomes, but few studies have explored these changes directly during these critical moments.
- In an experimental study with 18 female pigs, researchers examined sublingual microcirculation and overall blood flow during cardiac arrest and CPR using advanced video technology.
- Results indicated that microcirculation significantly declined during cardiac arrest but partially improved during CPR, with some parameters returning to 59-85% of baseline levels, highlighting the complex relationship between microcirculation and global hemodynamics.