Effect of Inhaled Nitric Oxide During LVAD-Based Resuscitation in Pigs: Echocardiography and Deformation Imaging Evaluation

Introduction: We have previously shown that primary survival after cardiac arrest (CA) can be improved by optimizing circulation during CPR using a minimal invasive left ventricular assist device (Impella 2.5, iCPR). Whether inhaled nitric oxid (iNO) will improve protection of the right ventricle (RV) is still unknown. Hypothesis: iNO preserves RV-function following CA by increasing transpulmonary flow (TPF). Methods: Ventricular fibrillation (VF) was electrically induced in 6 anesthetized pigs. Animals were left untreated for 10 min before iCPR was attempted. 3 pigs (iNO) had iNO starting 30 min post ROSC. In addition to invasive hemodynamic monitoring, all animals received transesophageal echocardiography at baseline, during untreated cardiac arrest, at the initiation of iCPR, 30 min, and 5 h following ROSC. Results: LV unloading was sufficient in both groups (LV-end-diastolic volume (mL): baseline and 5h after ROSC: iNO group: 58.4±8.4, 62.7±12.2; Control: 48.3±6.2, 52.9±7.6) (Fig. 1a). Preservation of...