Acute Kidney Injury After Cardiac Arrest Of Ventricular Fibrillation And Asphyxiation Swine Model: A Prospective Laboratory Study

Purposes:To investigate the renal function in ventricular fibrillation and asphyxiation cardiacarrest in a swine model and estimate the value of novel biomarkers in the acutekidney injury after cardiac arrest.Methods:32healthy inbred Wu-Zhi-Shan miniature piglets were randomized into two groups(n=16/group). Cardiac arrest was induced by programmed electric stimulation in theventricular fibrillation group and by clamping the endotracheal tube in theasphyxiation group. After untreated cardiac arrest for8mins, cardiopulmonaryresuscitation was done for return of spontaneous circulation (ROSC). After ROSC,animals received intensive care for6hours. Hemodynamics indexs were measuredcontinuously. Urine output was recorded per hour. Blood and urine samples werecollected for laboratory testing at baseline, immediately at ROSC,1hr after ROSC,2hrs after ROSC,3hrs after ROSC,4hrs after ROSC, and6hrs after ROSC.6hoursafter ROSC, the animals underwent euthanasia. Then right kidney was excised toobserve pathologic changes under a light microscope and a transmission electronmicroscope respectively.Results:100%(16/16) return of spontaneous circulation was observed in the ventricularfibrillation group and50%(8/16) in the asphyxiation group (p<0.01). All acutekidney injury biomarkers elevated significantly after return of spontaneous circulation.The novel biomarkers changed much earlier than the Cr did. The concentration of novel biomarkers in the asphyxiation group was higher than the ventricularfibrillation group.17out of21live animals suffered an oliguria and developed acutekidney injury. Characteristic morphological injuries in renal tissues were observedunder light microscope and transmission electron microscope, and were more seriousin the asphyxiation group.Conclusions:Acute kidney injury at early stage of post resuscitation is common in different causesof cardiac arrest. Asphyxiation suffers more severe kidney injury and gets worseprognosis.