Changes of endotheial glycocalyx layer after cadiopulmonary resuscitation in porcine model of cardiac arrest

Czech version

Authors: D.- Astapenko ^{1 3}; R. Škulec ^1,2,4,5; R. Černá Pařízková ^1,2; N. Pinterová ⁶; T. Hovanec ²; T. Mlýnková ²; J. Dudáková ⁴; M. Bílská ⁵; T. Pařízek ⁵; V. Radochová ⁷; V.- Černý ^{1 3,5,8}
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Hradec Králové ¹; Lékařská fakulta v Hradci Králové, Univerzita Karlova ²; Centrum pro výzkum a vývoj, Fakultní nemocnice Hradec Králové ³; Zdravotnická záchranná služba Středočeského kraje ⁴; Klinika anesteziologie, perioperační a intenzivní medicíny, Univerzita J. E. Purkyně v Ústí nad Labem, Masarykova nemocnice v Ústí nad Labem, Institut postgraduálního vzdělávání ve zdravotnictví Praha ⁵; Přírodovědecká fakulta v Praze, Univerzita Karlova ⁶; Fakulta vojenského zdravotnictví, Univerzita obrany v Brně ⁷; Dept. of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Canada ⁸
Published in: Anest. intenziv. Med., 31, 2020, č. 5, s. 212-216
Category: Original Article

Overview

Objective: Endothelial glycocalyx (EG) plays key role in maintaining vascular integrity. Perturbation of the EG in patients after cardiac arrest has been described by measuring syndecan-1 and heparan sulphate levels. Non-invasive method of evaluating EG thickness by using Perfused Boundary Region (PBR) has been introduced recently. PBR represents the amount of lateral deviation of red blood cells towards the EG in µm. The aim of the study was to evaluate changes in PBR on porcine model of cardiac arrest in order to assess the usefulness of PBR as an indicator of glycocalyx damage.

Design: Experimental study on a porcine model of cardiac arrest.

Material and Methods: Cardiac arrest was induced by intracardiac electrode triggering ventricular fibrillation and treated by defibrillation after 15 minutes in accordance with 2015 ERC guidelines. Sublingual microcirculation was measured by hand-held microscope working on the principle of orthogonal spectral imaging and PBR was computed automatically with specialized software in three timepoints. At baseline (PBR_B), after return of spontaneous circulation (PBR_ROSC) and 20 minutes after ROSC (PBR_ROSC_20).

Results: PBR data was obtained from 11 pigs. There was insignificant increase of PBR after ROSC (p = 0.47). The PBR_B was 2.129 (± 0.21), PBR_ROSC was 2.206 (± 0.27) and PBR_ROSC_20 was 2.18 (± 0.19), data are presented as mean and standard deviation.

Conclusions: Our data demonstrate insignificant increase of PBR after cardiac arrest in pig. The value of PBR as an indicator of EG shedding requires further study before introducing this parameter as a routine non-invasive tool in pig model of cardiac arrest.

Keywords:

endothelial glycocalyx – Cardiac arrest – cardiopulmonary resuscitation

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