Anisodamine hydrobromide ameliorated cardiac damage after resuscitation

Abstract Background: The microcirculation is correlated with the prognosis of patients with cardiac arrest and changes after resuscitation. Methods: This study was to study effects of anisodamine hydrobromide (AH) on microcirculation and explore its potential mechanisms. Twenty-four pigs were randomly grouped into three groups (n = 8): Sham, Saline and AH group. After pigs were anesthetized, intubated and mechanically ventilated, ventricular fibrillation (VF) was induced by electrical stimulation. After 8 mins, cardiopulmonary resuscitation (CPR) was given to the restoration of spontaneous circulation (ROSC). Arteriovenous blood was collected at baseline and 0, 1, 2, 4, and 6 hrs after ROSC to measure blood gas and cytokines. Perfused vessel density (PVD) and microvascular flow index (MFI) were measured to reflect the microcirculation. Continuous cardiac output (CO) and global ejection fraction (GEF) were measured to indicate hemodynamics. Results: Compared with Sham group, PVD and MFI in the intestines and the sublingual regions decreased significantly after resuscitation. The microcirculation recovered faster in the AH group than the SA group. The decrease of intestinal microcirculatory blood flow was closely related to the decrease of sublingual microcirculatory blood flow. The cardiac function was impaired after resuscitation, and a decrease in the ratio of cytokine IFN-γ/IL-4 suggested the immune imbalance. The microcirculation changes in sublingual regions were closely related to the changes in intestines. Conclusion: AH could improve the immune imbalance after resuscitation and was beneficial to the recovery of cardiac function.