Abstract 17679: A Randomized Pilot Trial of Intra-arrest Cyclosporine and Methylprednisolone for Attenuation of Post-arrest Myocardial Dysfunction

Introduction: Myocardial dysfunction is common after cardiac arrest and may result from the systemic inflammatory response syndrome. It is unknown if immunosuppressants can prevent myocardial dysfunction post cardiac arrest. Hypothesis: Intra-arrest cyclosporine (CCY) and methylprednisolone (MP) will preserve cardiac output (CO), left ventricular ejection fraction (LVEF) and mean arterial pressure (MAP) after return of spontaneous circulation (ROSC). Methods: We performed a randomized, blinded placebo-controlled pilot. Ten female swine, 25-30kg, were anesthetized with fentanyl and midazolam. We placed femoral arterial and venous sheaths and introduced an arterial Millar pressure transducer and a continuous CO catheter (Edwards LifeScience) into the pulmonary artery. Ventricular fibrillation was induced by transthoracic shock and allowed to continue for 8min after which we began ACLS and administered either 10 mg/kg CCY + 40mg MP or placebo. Animals with ROSC were supported for 12h using norepinephrine as ...