Objective: To investigate the effect of urokinase on cerebral microcirculatory perfusion after cardiopulmonary resuscitation (CPR) in rabbits after cardiac arrest (CA).
Methods: Twenty New Zealand rabbits were assorted into drug thrombolysis group and routine CPR group by randomized digital method with 10 in each group. Potassium chloride injection combined with asphyxia was employed to establish the CA model, CPR and basic life-support were performed in routine CPR group. Following the above treatments, 20 kU/kg urokinase was given in thrombolysis group. The relative cerebral blood flow (rCBF), cerebral blood volume (rCBV) and top teep time (rTTP) were observed by dual-slice spiral CT cerebral perfusion imaging in order to investigate the effect of urokinase on cerebral microcirculatory perfusion in rabbits.
Results: rCBF and rCBV in thrombolysis group were significantly higher than those in routine CPR group (rCBF: 1.248±0.139 vs 0.900±0.070, t=6.870, P=0.000; rCBV: 1.206±0.117 vs. 0.969±0.067, t=6.156, P=0.000), and rTTP in thrombolysis group was significantly shorter than that in routine CPR group (0.950±0.037 vs. 1.015±0.026, t=3.777, P=0.004). The cerebral perfusion in thrombolysis group was obviously better than routine CPR group. There were no significant differences in the time for restoration of spontaneous circulation (ROSC), the time for restoration of spontaneous breathing or mean arterial pressure (MAP between routine CPR group and thrombolysis group [ time of ROSC (s): 307.9±96.4 vs. 242.0±71.0, t=-1.741, P=0.099; time of restoration of spontaneous breathing (minutes): 20.6±12.5 vs. 19.3±10.1, t= -0.256, P=0.801; MAP (mm Hg, 1 mm Hg=0.133 kPa): 65.5 = 6.2 vs 69.0±6.7, t=1.217, P=0.239].
Conclusion: Thrombolytic therapy with urokinase in CPR could improve the cerebral microcirculatory perfusion in CA rabbits.