Acute kidney injury after cardiac arrest of ventricular fibrillation and asphyxiation swine model

Am J Emerg Med. 2014 Mar;32(3):208-15. doi: 10.1016/j.ajem.2013.10.043. Epub 2013 Nov 4.

Abstract

Purposes: The purposes of the study are to investigate the renal function in ventricular fibrillation (VF) and asphyxiation cardiac arrest in a swine model and to estimate the value of novel biomarkers in the acute kidney injury (AKI) after cardiac arrest.

Method: Thirty-two healthy inbred Wu-Zhi-Shan miniature piglets were randomized into 2 groups (n = 16 per group). Cardiac arrest was induced by programmed electric stimulation and clamping the endotracheal tube in the VF group and asphyxiation group, respectively. Cardiopulmonary resuscitation was done for return of spontaneous circulation (ROSC).

Results: One hundred percent (16/16) ROSC was observed in the VF group, and 50% (8/16) in the asphyxiation group (P < .01). All AKI biomarkers elevated significantly after ROSC. The novel biomarkers changed much earlier than the creatinine. The concentration of novel biomarkers in the asphyxiation group was higher than the VF group. Live animals had an oliguria and developed AKI. Characteristic morphological injuries in renal tissues were observed under light microscope and transmission electron microscope and were more serious in the asphyxiation group.

Conclusions: Acute kidney injury at early stage of postresuscitation is common in different causes of cardiac arrest. Asphyxiation has more severe kidney injury and gets worse prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / urine
  • Animals
  • Asphyxia / complications*
  • Asphyxia / mortality
  • Biomarkers / blood
  • Biomarkers / urine
  • Cardiopulmonary Resuscitation
  • Female
  • Heart Arrest / etiology*
  • Heart Arrest / mortality
  • Heart Arrest / physiopathology
  • Heart Arrest / therapy
  • Male
  • Prognosis
  • Prospective Studies
  • Random Allocation
  • Severity of Illness Index
  • Survival Rate
  • Swine
  • Ventricular Fibrillation / complications*
  • Ventricular Fibrillation / mortality

Substances

  • Biomarkers