[The effects of CDP-Choline on the improvement of the successful rate of cardiopulmonary resuscitation and post-resuscitation cardiac function].

OBJECTIVE: To investigate the effects of CDP-Choline on the improvement of recovery of spontaneous circulation (ROSC) and protection against myocardial injury in cardiopulmonary resuscitation (CPR).

METHODS: Sprague-Dawley (SD) rats were randomized into four groups: control group (n=5, no asphyxia), model group (n=10), adrenaline group (n=10) and CDP-Choline group (n=10). Cardiac arrest (CA) was induced by asphyxia, and then CPR was initiated. Drugs were administered at 5 minutes before CPR and at the initiation of CPR. Equal amount of normal saline was given in the control group and the model group. The hemodynamic parameters were monitored during CPR and after ROSC. After 2 hours, the myocardial tissue of the rats was harvested to assess the degree of ischemia/reperfusion (I/R) injury by measuring ATPase activity, superoxide dismutase (SOD) activity and malondialdehyde (MDA) content.

RESULTS: Compared with the model group, the rate of ROSC was significantly elevated (90%, 80% vs. 20%, both P<0.01) in the CDP-Choline group and the adrenaline group, the time of achieving ROSC was shorter (53±10 s, 55±9 s vs. 95±7 s, both P<0.01), and the heart rate (HR) and mean arterial pressure (MAP) at 2 hours after CPR were higher (HR: 222.78±41.55 bpm, 167.75±11.76 bpm vs. 131.50±0.70 bpm; MAP: 36.53±8.69 mm Hg, 39.30±6.45 mm Hg vs. 30.19±5.15 mm Hg, all P<0.01). The cardiac function [the maximal rate of left ventricular pressure increase/decline (±dp/dt max)] in the CDP-Choline group was gradually stabilized and significantly higher than that in the model and the adrenaline groups. The cardiac function in the adrenaline group was higher than that of the model group, but it was in a tendency of lowering. Compared with the model group and the adrenaline group, the reduction of Na(+)-K(+)-ATPase and SOD activity were significantly increased in the CDP-Choline group (Na(+)-K(+)-ATPase: 7.35±0.20 μmol×mg(-1)×h(-1) vs. 5.11±0.69 μmol×mg(-1)×h(-1), 4.70±0.41 μmol×mg(-1)×h(-1); SOD activity: 320.65±47.25 U/mg vs. 225.79±24.64 U/mg, 253.67±12.00 U/mg, all P<0.01), and myocardial MDA content in the CDP-Choline group was significantly lower than that in the model group and the adrenaline group (8.19±1.64 mmol/mg vs. 16.59±1.27 mmol/mg, 14.65±0.93 mmol/mg, both P<0.01) . There was no significant difference in the measured parameters between the CDP-Choline group and the control group, and also between the model group and the adrenaline group.

CONCLUSION: CDP-Choline has the effect on improvement of the successful rate of CPR, and it shows an obvious myocardial protection against I/R compared with adrenaline.