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Published in: Intensive Care Medicine 4/2010

01-04-2010 | Pediatric Brief Report

Chest compressions versus ventilation plus chest compressions in a pediatric asphyxial cardiac arrest animal model

Authors: Jose María Iglesias, Jesús López-Herce, Javier Urbano, Maria José Solana, Santiago Mencía, Jimena del Castillo

Published in: Intensive Care Medicine | Issue 4/2010

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Abstract

Objective

To compare the ventilation achieved with chest compressions (CC) or ventilation plus compressions (VC) in a pediatric animal model of cardiac arrest.

Design

Randomized experimental study.

Setting

Experimental department of a University Hospital.

Methods

Twelve infant pigs with asphyxial cardiac arrest. Sequential 3-min periods of VC and CC were performed for a total duration of 9 min. Tidal volume (TV), end-tidal CO2 (EtCO2), mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary arterial pressure (mPAP), and peripheral, cerebral, and renal saturations were recorded and arterial and venous blood gases were analyzed.

Results

VC achieved a TV similar to the preset parameters on the ventilator, whilst the TV in CC was very low (P < 0.001). EtCO2 with VC was significantly higher than with CC (14.0 vs. 3.9 mmHg, P < 0.05). Arterial pH was higher with VC than with CC (6.99 vs. 6.90 mmHg, P < 0.05). Arterial PCO2 was lower with VC than with CC (62.1 vs. 97.0 mmHg, P < 0.05). There were no significant differences in the MAP; CVP; mPAP; peripheral, renal, and cerebral saturations; or lactate concentrations between the two techniques.

Conclusions

VC achieves better ventilation than CC during cardiopulmonary resuscitation and has no negative effect on the hemodynamic situation.
Literature
1.
go back to reference International Liaison Committee on Resuscitation (2006) The International Liaison Committee on Resuscitation (ILCOR) consensus on science with treatment recommendations for pediatric and neonatal patients: pediatric basic and advanced life support. Pediatrics 117:e955–e977CrossRef International Liaison Committee on Resuscitation (2006) The International Liaison Committee on Resuscitation (ILCOR) consensus on science with treatment recommendations for pediatric and neonatal patients: pediatric basic and advanced life support. Pediatrics 117:e955–e977CrossRef
2.
go back to reference Sherman M (2007) The new American Heart Association cardiopulmonary resuscitation guidelines: should children and adults have to share? Curr Opin Pediatr 19:253–257CrossRefPubMed Sherman M (2007) The new American Heart Association cardiopulmonary resuscitation guidelines: should children and adults have to share? Curr Opin Pediatr 19:253–257CrossRefPubMed
3.
go back to reference Ewy GA, Zuercher M, Hilwig RW, Sanders AB, Berg RA, Otto CW, Hayes MM, Kern KB (2007) Improved neurological outcome with continuous chest compressions compared with 30:2 compressions-to-ventilations cardiopulmonary resuscitation in a realistic swine model of out-of-hospital cardiac arrest. Circulation 116:2525–2530CrossRefPubMed Ewy GA, Zuercher M, Hilwig RW, Sanders AB, Berg RA, Otto CW, Hayes MM, Kern KB (2007) Improved neurological outcome with continuous chest compressions compared with 30:2 compressions-to-ventilations cardiopulmonary resuscitation in a realistic swine model of out-of-hospital cardiac arrest. Circulation 116:2525–2530CrossRefPubMed
4.
go back to reference Berg RA, Kern KB, Hilwig RW, Berg MD, Sanders AB, Otto CW, Ewy GA (1997) Assisted ventilation does not improve outcome in a porcine model of single-rescuer bystander cardiopulmonary resuscitation. Circulation 95:1635–1641PubMed Berg RA, Kern KB, Hilwig RW, Berg MD, Sanders AB, Otto CW, Ewy GA (1997) Assisted ventilation does not improve outcome in a porcine model of single-rescuer bystander cardiopulmonary resuscitation. Circulation 95:1635–1641PubMed
5.
go back to reference Berg RA, Kern KB, Sanders AB, Otto CW, Hilwig RW, Ewy GA (1993) Bystander cardiopulmonary resuscitation: is ventilation necessary? Circulation 88(4 Pt 1):1907–1915PubMed Berg RA, Kern KB, Sanders AB, Otto CW, Hilwig RW, Ewy GA (1993) Bystander cardiopulmonary resuscitation: is ventilation necessary? Circulation 88(4 Pt 1):1907–1915PubMed
6.
go back to reference Noc M, Weil MH, Tang W, Turner T, Fukui M (1995) Mechanical ventilation may not be essential for initial cardiopulmonary resuscitation. Chest 108:821–827CrossRefPubMed Noc M, Weil MH, Tang W, Turner T, Fukui M (1995) Mechanical ventilation may not be essential for initial cardiopulmonary resuscitation. Chest 108:821–827CrossRefPubMed
7.
go back to reference Kern KB, Hilwig RW, Berg RA, Ewy GA (1998) Efficacy of chest compression-only BLS CPR in the presence of an occluded airway. Resuscitation 39:179–188CrossRefPubMed Kern KB, Hilwig RW, Berg RA, Ewy GA (1998) Efficacy of chest compression-only BLS CPR in the presence of an occluded airway. Resuscitation 39:179–188CrossRefPubMed
8.
go back to reference Chandra NC, Gruben KG, Tsitlik JE, Brower R, Guerci AD, Halperin HH, Weisfeldt ML, Permutt S (1994) Observations of ventilation during resuscitation in a canine model. Circulation 90:3070–3075PubMed Chandra NC, Gruben KG, Tsitlik JE, Brower R, Guerci AD, Halperin HH, Weisfeldt ML, Permutt S (1994) Observations of ventilation during resuscitation in a canine model. Circulation 90:3070–3075PubMed
9.
go back to reference SOS-KANTO Study Group (2007) Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study. Lancet 369:920–926CrossRef SOS-KANTO Study Group (2007) Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study. Lancet 369:920–926CrossRef
10.
go back to reference Iwami T, Kawamura T, Hiraide A, Berg RA, Hayashi Y, Nishiuchi T, Kajino K, Yonemoto N, Yukioka H, Sugimoto H, Kakuchi H, Sase K, Yokoyama H, Nonogi H (2007) Effectiveness of bystander-initiated cardiac-only resuscitation for patients with out-of-hospital cardiac arrest. Circulation 116:2900–2907CrossRefPubMed Iwami T, Kawamura T, Hiraide A, Berg RA, Hayashi Y, Nishiuchi T, Kajino K, Yonemoto N, Yukioka H, Sugimoto H, Kakuchi H, Sase K, Yokoyama H, Nonogi H (2007) Effectiveness of bystander-initiated cardiac-only resuscitation for patients with out-of-hospital cardiac arrest. Circulation 116:2900–2907CrossRefPubMed
11.
go back to reference Ong ME, Ng FS, Anushia P, Tham LP, Leong BS, Ong VY, Tiah L, Lim SH, Anantharaman V (2008) Comparison of chest compression only and standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest in Singapore. Resuscitation 78:119–126CrossRefPubMed Ong ME, Ng FS, Anushia P, Tham LP, Leong BS, Ong VY, Tiah L, Lim SH, Anantharaman V (2008) Comparison of chest compression only and standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest in Singapore. Resuscitation 78:119–126CrossRefPubMed
12.
go back to reference Berg RA, Hilwig RW, Kern KB, Babar I, Ewy GA (1999) Simulated mouth-to-mouth ventilation and chest compressions (bystander cardiopulmonary resuscitation) improves outcome in a swine model of prehospital pediatric asphyxial cardiac arrest. Crit Care Med 27:1893–1899CrossRefPubMed Berg RA, Hilwig RW, Kern KB, Babar I, Ewy GA (1999) Simulated mouth-to-mouth ventilation and chest compressions (bystander cardiopulmonary resuscitation) improves outcome in a swine model of prehospital pediatric asphyxial cardiac arrest. Crit Care Med 27:1893–1899CrossRefPubMed
13.
go back to reference Berg RA, Hilwig RW, Kern KB, Ewy GA (2000) Bystander chest compressions and assisted ventilation independently improve outcome from piglet asphyxial pulseless cardiac arrest. Circulation 101:1743–1748PubMed Berg RA, Hilwig RW, Kern KB, Ewy GA (2000) Bystander chest compressions and assisted ventilation independently improve outcome from piglet asphyxial pulseless cardiac arrest. Circulation 101:1743–1748PubMed
14.
go back to reference Berg RA (2000) Role of mouth-to-mouth rescue breathing in bystander cardiopulmonary resuscitation for asphyxial cardiac arrest. Crit Care Med 28(Suppl 11):193–195CrossRef Berg RA (2000) Role of mouth-to-mouth rescue breathing in bystander cardiopulmonary resuscitation for asphyxial cardiac arrest. Crit Care Med 28(Suppl 11):193–195CrossRef
15.
go back to reference Idris AH, Banner MJ, Wenzel V, Fuerst RS, Becker LB, Melker RJ (1994) Ventilation caused by external chest compression is unable to sustain effective gas exchange during CPR: a comparison with mechanical ventilation. Resuscitation 28:143–150CrossRefPubMed Idris AH, Banner MJ, Wenzel V, Fuerst RS, Becker LB, Melker RJ (1994) Ventilation caused by external chest compression is unable to sustain effective gas exchange during CPR: a comparison with mechanical ventilation. Resuscitation 28:143–150CrossRefPubMed
16.
go back to reference Deakin CD, O’Neill JF, Tabor T (2007) Does compression-only cardiopulmonary resuscitation generate adequate passive ventilation during cardiac arrest? Resuscitation 75:53–59CrossRefPubMed Deakin CD, O’Neill JF, Tabor T (2007) Does compression-only cardiopulmonary resuscitation generate adequate passive ventilation during cardiac arrest? Resuscitation 75:53–59CrossRefPubMed
17.
go back to reference Bobrow BJ, Zuercher M, Ewy GA, Clark L, Chikani V, Donahue D, Sanders AB, Hilwig RW, Berg RA, Kern KB (2008) Gasping during cardiac arrest in humans is frequent and associated with improved survival. Circulation 118:2550–2554CrossRefPubMed Bobrow BJ, Zuercher M, Ewy GA, Clark L, Chikani V, Donahue D, Sanders AB, Hilwig RW, Berg RA, Kern KB (2008) Gasping during cardiac arrest in humans is frequent and associated with improved survival. Circulation 118:2550–2554CrossRefPubMed
18.
go back to reference Dorph E, Wik L, Stromme TA, Eriksen M, Steen PA (2004) Oxygen delivery and return of spontaneous circulation with ventilation: compression ratio 2:30 versus chest compressions only CPR in pigs. Resuscitation 60:309–318CrossRefPubMed Dorph E, Wik L, Stromme TA, Eriksen M, Steen PA (2004) Oxygen delivery and return of spontaneous circulation with ventilation: compression ratio 2:30 versus chest compressions only CPR in pigs. Resuscitation 60:309–318CrossRefPubMed
19.
go back to reference Steen PA (2007) Does active rescuer ventilation have a place during basic cardiopulmonary resuscitation? Circulation 116:2514–2516CrossRefPubMed Steen PA (2007) Does active rescuer ventilation have a place during basic cardiopulmonary resuscitation? Circulation 116:2514–2516CrossRefPubMed
20.
go back to reference Lurie KG, Yannopoulos D, McKnite SH, Herman ML, Idris AH, Nadkarni VM, Tang W, Gabrielli A, Barnes TA, Metzger AK (2008) Comparison of a 10-breaths-per-minute versus a 2-breaths-per-minute strategy during cardiopulmonary resuscitation in a porcine model of cardiac arrest. Respir Care 53:862–870PubMed Lurie KG, Yannopoulos D, McKnite SH, Herman ML, Idris AH, Nadkarni VM, Tang W, Gabrielli A, Barnes TA, Metzger AK (2008) Comparison of a 10-breaths-per-minute versus a 2-breaths-per-minute strategy during cardiopulmonary resuscitation in a porcine model of cardiac arrest. Respir Care 53:862–870PubMed
Metadata
Title
Chest compressions versus ventilation plus chest compressions in a pediatric asphyxial cardiac arrest animal model
Authors
Jose María Iglesias
Jesús López-Herce
Javier Urbano
Maria José Solana
Santiago Mencía
Jimena del Castillo
Publication date
01-04-2010
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 4/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-010-1777-9

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