Extracorporeal Cardiopulmonary Resuscitation Guided by End-Tidal Carbon Dioxide—a Porcine Model

Extracorporeal membrane cardiopulmonary resuscitation (ECPR) during cardiopulmonary resuscitation (CPR) for selected cases and end-tidal carbon dioxide (ETCO 2 ) could be used to guide initiation of ECPR. Ventricular fibrillation was induced in 12 pigs and CPR was performed until ETCO 2 fell below 10 mmHg; then, ECPR was performed. Animals were divided into group short (G Short ) and group long (G Long ), according to time of CPR. Carotid blood flow was higher ( p = 0.02) and mean arterial blood pressure lower in G Long during CPR ( p < 0.05). B-Lactate was lower and pH higher in G Short ( p < 0.01). In microdialysis lactate-pyruvate ratio, glycerol and glutamate increased in both groups during CPR, but considerably in G Long ( p < 0.01). No difference could be seen in histopathology of the brain or kidney post-ECPR. No apparent histological differences of tissue damage in brains or levels of S100B in plasma were detected between groups. This might suggest that ETCO 2 could be used as a marker for brain injury following ECPR. Graphical abstract