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BMC Cardiovascular Disorders

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Open Access 01-12-2010 | Research article

Manual versus mechanical cardiopulmonary resuscitation. An experimental study in pigs

Authors: Qiuming Liao, Trygve Sjöberg, Audrius Paskevicius, Björn Wohlfart, Stig Steen

Published in: BMC Cardiovascular Disorders | Issue 1/2010

Abstract

Background

Optimal manual closed chest compressions are difficult to give. A mechanical compression/decompression device, named LUCAS, is programmed to give compression according to the latest international guidelines (2005) for cardiopulmonary resuscitation (CPR). The aim of the present study was to compare manual CPR with LUCAS-CPR.

Methods

30 kg pigs were anesthetized and intubated. After a base-line period and five minutes of ventricular fibrillation, manual CPR (n = 8) or LUCAS-CPR (n = 8) was started and run for 20 minutes. Professional paramedics gave manual chest compression's alternating in 2-minute periods. Ventilation, one breath for each 10 compressions, was given to all animals. Defibrillation and, if needed, adrenaline were given to obtain a return of spontaneous circulation (ROSC).

Results

The mean coronary perfusion pressure was significantly (p < 0.01) higher in the mechanical group, around 20 mmHg, compared to around 5 mmHg in the manual group. In the manual group 54 rib fractures occurred compared to 33 in the LUCAS group (p < 0.01). In the manual group one severe liver injury and one pressure pneumothorax were also seen. All 8 pigs in the mechanical group achieved ROSC, as compared with 3 pigs in the manual group.

Conclusions

LUCAS-CPR gave significantly higher coronary perfusion pressure and significantly fewer rib fractures than manual CPR in this porcine model.

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Hightower D, Thomas SH, Stone CK, Dunn K, March JA: Decay in quality of closed-chest compressions over time. Ann Emerg Med. 1995, 26: 300-303. 10.1016/S0196-0644(95)70076-5.CrossRefPubMed

Sunde L, Wik K, Steen PA: Quality of mechanical, manual standard and active compression-decompression CPR on the arrest site and during transport in a manikin model. Resuscitation. 1997, 34: 235-242. 10.1016/S0300-9572(96)01087-8.CrossRefPubMed

Ocha FJ, Ramalle-Gómara E, Lisa V, Saralegui I: The effect of rescuer fatigue on the quality of chest compressions. Resuscitation. 1998, 37: 149-152. 10.1016/S0300-9572(98)00057-4.CrossRef

Thorén AB, Axelsson A, Holmberg S, Herlitz J: Measurement of skills in cardiopulmonary resuscitation - do professionals follow given guidelines?. Eur J Emerg Med. 2001, 8: 169-176. 10.1097/00063110-200109000-00002.CrossRefPubMed

Ashton A, McCluskey A, Gwinnutt CL, Keenan AM: Effect of rescuer fatigue on performance of continuous external chest compressions over 3 min. Resuscitation. 2002, 55: 151-155. 10.1016/S0300-9572(02)00168-5.CrossRefPubMed

Wik L, Kramer-Johansen J Myklebust H, Sørebø H, Svensson L, Fellows B, Steen PA: Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA. 2005, 293: 299-304. 10.1001/jama.293.3.299.CrossRefPubMed

Heidenreich JW, Berg RA, Higdon TA, Ewy GA, Kern KB, Sanders AB: Rescuer fatigue: standard versus continuous chest-compression cardiopulmonary resuscitation. Acad Emerg Med. 2006, 13: 1020-1026. 10.1111/j.1553-2712.2006.tb00272.x.CrossRefPubMed

Aufderheide TP, Pirrallo RG, Yannopoulos D, Klein JP, von C, Sparks CW, Deja KA, Kitscha DJ, Provo TA, Lurie KG: Incomplete chest wall decompression: a clinical evaluation of CPR performance by trained laypersons and an assessment of alternative manual chest compression-decompression techniques. Resuscitation. 2006, 71: 341-351. 10.1016/j.resuscitation.2006.03.021.CrossRefPubMed

Kim JA, Vogel D, Guimond G, Hostler D, Wang HE, Menegazzi JJ: A randomized, controlled comparison of cardiopulmonary resuscitation performed on the floor and on a moving ambulance stretcher. Prehosp Emerg Care. 2006, 10: 68-70. 10.1080/10903120500373108.CrossRefPubMed

10.

Edelson DP, Abella BS, Kramer-Johansen J, Wik L, Myklebust H, Barry AM, Merchant RM, Hoek TL, Steen PA, Becker LB: Effect of compression depth and pre-shock pauses predict defibrillation failure during cardiac arrest. Resuscitation. 2006, 71: 137-145. 10.1016/j.resuscitation.2006.04.008.CrossRefPubMed

11.

Olasveegen TM, Tomlison AE, Wik L, Sunde K, Steen PA, Myklbust H, Kramer-Johansen J: A failed attempt to improve quality of out-of-hospital CPR through performance evaluation. Prehosp Emerg Care. 2007, 11: 427-433. 10.1080/10903120701536628.CrossRef

12.

European Resuscitation Council: Guidelines 2005. Resuscitation. 2005, 67S1-

13.

2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circ. 2005, 112-

14.

Steen S, Liao Q, Pierre L, Paskevicius A, Sjöberg T: Evaluation of LUCAS, a new device for automatic mechanical compression and decompression resuscitation. Resuscitation. 2002, 55: 285-299. 10.1016/S0300-9572(02)00271-X.CrossRefPubMed

15.

Steen S, Liao Q, Pierre L, Paskevicius A, Sjöberg T: The critical importance of minimal delay between chest compressions and subsequent defibrillation: a haemodynamic explantation. Resuscitation. 2003, 58: 249-258. 10.1016/S0300-9572(03)00265-X.CrossRefPubMed

16.

Rubertsson S, Karlsten R: Increased cortical cerebral blood flow with LUCAS, a new device for mechanical chest compressions compared to standard external compressions during experimental cardiopulmonary resuscitation. Resuscitation. 2005, 65: 357-363. 10.1016/j.resuscitation.2004.12.006.CrossRefPubMed

17.

Steen S, Sjöberg T, Olsson P, Young M: Treatment of out-of-hospital cardiac arrest with LUCAS, a new device for automatic mechanical compression and active decompression resuscitation. Resuscitation. 2005, 67: 25-30. 10.1016/j.resuscitation.2005.05.013.CrossRefPubMed

18.

Nielsen N, Sandhall L, Scherstén F, Friberg H, Olsson SE: Successful resuscitation with mechanical CPR, therapeutic hypothermia and coronary intervention during manual CPR after out-of-hospital cardiac arrest. Resuscitation. 2005, 65: 111-3. 10.1016/j.resuscitation.2004.11.007.CrossRefPubMed

19.

Smekal D, Johansson J, Huzrvka T, Rubertsson S: No difference in autopsy detected injuries in cardiac arrest patients treated with manual chest compared with mechanical compressions with the LUCAS TM device - A pilot study. Resuscitation. 2009, 80: 1104-7. 10.1016/j.resuscitation.2009.06.010.CrossRefPubMed

20.

Paradis NA, Martin GB, Rivers EP, et al: Coronary perfusion pressure and the return of spontaneous circulation in human cardiopulmonary resuscitation. JAMA. 1990, 263: 1106-1113. 10.1001/jama.263.8.1106.CrossRefPubMed

21.

Levine RL, Wayne MA, Miller CC: End-tidal carbon dioxide and outcome of out-of-hospital cardiac arrest. N Engl J Med. 1997, 337: 301-306. 10.1056/NEJM199707313370503.CrossRefPubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2261/10/53/prepub

Title: Manual versus mechanical cardiopulmonary resuscitation. An experimental study in pigs
Authors: Qiuming Liao
Trygve Sjöberg
Audrius Paskevicius
Björn Wohlfart
Stig Steen
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: BMC Cardiovascular Disorders / Issue 1/2010
Electronic ISSN: 1471-2261
DOI: https://doi.org/10.1186/1471-2261-10-53

2024 ASCO Annual Meeting

Springer Medicine

Manual versus mechanical cardiopulmonary resuscitation. An experimental study in pigs

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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