Harald Arne Bergan has sucessfully used extracorporeal membrane oxygenation (ECMO) as a method to resuscitate pigs after long-lasting cardiac arrest.

MAIN RESULTS:

1. Eight of eight pigs with cardiac arrest were successfully resusciated with a novel ECMO strategy.
2. Hypothermia had no effect in extracorporeal cardiopulmonary resuscitation.
3. Beta-blocker treatment might enhance the negative effect of hypothermia on cardiac function.

THESIS DEFENCE:

Thesis: Cardiac Effects of ECMO Cardiopulmonary Resuscitation and Beta1-Adrenergic Receptor Blockade During Hypothermia
Candidate: Harald Arne Bergan
Time: December 3, 2018 at 13:15
Place: Oslo University Hospital, Rikshospitalet: Blue auditorium
Link to university website

SUMMARY:

(1) Extracorporeal membrane oxygenation (ECMO) oxygenates red blood cells and removes carbon dioxide from a person’s blood with technology largely derived from cardiopulmonary bypass. The technique is mostly used to provide cardiac and respiratory support in the late stage of profound heart or lung failure, but it could also be used during resuscitation from cardiac arrest.

The first article of Bergan’s thesis demonstrates a successful strategy of extracorporeal cardiopulmonary resuscitation. Eight pigs with ventricular fibrillation of 15 minutes were resuscitated and hemodynamically stabilised post-arrest. Left ventricular function and stroke volume were decreased by 50 % following the procedure.

(2) Therapeutic hypothermia has no effect in preservation of cardiac function following extracorporeal cardiopulmonary resuscitation. 20 pigs were randomized to extracorporeal cardiopulmonary resuscitation with or without two-hour therapeutic hypothermia. All animals suffered severe systolic dysfunction and myocardial injury with no difference between the two groups.

(3) Infusion of the beta-blocker esmolol exacerbates the negative effects of hypothermia on both systolic and diastolic heart function. The experiment was conducted on ten non-arrested healthy pig hearts during spontaneous and pacing-increased heart rates. Compared to normothermia and no esmolol infusion, the combination of both treatments reduced myocardioal velocities by approximately 40 %.

REFERENCES:

(1) Bergan, H. A., Halvorsen, P. S., Skulstad, H., Edvardsen, T., Fosse, E., & Bugge, J. F. (2015). Successful ECMO-cardiopulmonary resuscitation with the associated post-arrest cardiac dysfunction as demonstrated by MRI. Intensive care medicine experimental, 3(1), 25.

(2) Bergan, H. A., Halvorsen, P. S., Skulstad, H., Fosse, E., & Bugge, J. F. (2016). Does therapeutic hypothermia during extracorporeal cardiopulmonary resuscitation preserve cardiac function?. Journal of translational medicine, 14(1), 345.

(3) Bergan, H. A., Halvorsen, P. S., Espinoza, A., Kerans, V., Skulstad, H., Fosse, E., & Bugge, J. F. (2018). Left Ventricle Function During Therapeutic Hypothermia with Beta1-Adrenergic Receptor Blockade. Therapeutic hypothermia and temperature management.