{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T16:34:39Z","timestamp":1773160479684,"version":"3.50.1"},"reference-count":56,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,2,21]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The primary objective was to develop a porcine model of prolonged (30 or 60 minutes) pediatric cardiopulmonary resuscitation (CPR) followed by 22\u2010 to 24\u2010hour survival with extracorporeal life support, and secondarily to evaluate differences in neurologic injury.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Ten\u2010kilogram, 4\u2010week\u2010old female piglets were used. First, model development established the technique (n=8). Then, a pilot study was conducted (n=15). After 80% survival was achieved in the final 5 pilot animals, a proof\u2010of\u2010concept randomized study was completed (n=11). Shams (n=6) underwent anesthesia only. Severe neurological injury was determined by a composite score of mitochondrial function, neuropathology, and cerebral metabolism: scale of 0\u20136 (severe: &gt;3). Among 15 piglets in the pilot study, overall survival was 10 (67%); of the final 5, overall survival was 4 (80%). Eleven piglets were then randomized to 60 (CPR60, n=5) or 30 minutes of CPR (CPR30, n=5); 1 animal was excluded from prerandomization for intra\u2010abdominal hemorrhage (10\/11, 91% survival). Three of 5 animals in the CPR60 group had severe neurological injury scores versus 1 of 5 in the CPR30 group (\n              <jats:italic>P<\/jats:italic>\n              =0.52). During ECMO, CPR60 animals had lower pH (CPR60: 7.4 [IQR 7.4\u20137.4] versus CPR30: 7.5 [IQR 7.4\u20137.5],\n              <jats:italic>P<\/jats:italic>\n              =0.022), higher lactate (CPR60: 6.8 [IQR 6.8\u201311] versus CPR30: 4.2 [IQR 4.1\u20134.3] mmol\/L;\n              <jats:italic>P<\/jats:italic>\n              =0.012), and higher ICP (CPR60: 19.3 [IQR 11.7\u201329.3] versus CPR30: 7.9 [IQR 6.7\u20139.3] mm\u2009Hg;\n              <jats:italic>P<\/jats:italic>\n              =0.037). Both groups had greater mitochondrial injury than shams (CPR60:\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; CPR30:\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). CPR60 did not differ from CPR30 in mitochondrial respiration, neuropathology, or cerebral metabolism.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">A pediatric porcine model of extracorporeal cardiopulmonary resuscitation after 60 and 30 minutes of CPR consistently resulted in 24\u2010hour survival with more severe lactic acidosis in the 60\u2010minute cohort.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.026479","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T12:16:51Z","timestamp":1676981811000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Pediatric Extracorporeal Cardiopulmonary Resuscitation: Development of a Porcine Model and the Influence of Cardiopulmonary Resuscitation Duration on Brain 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