Abstract 210: Goal-Directed CPR is Less Effective With an Increased Interval From Cardiac Arrest Onset to Initiation of Chest Compressions
| Autor: | Cindy H. Hsu, Matias Caceres, Alvaro Rojas-Pena, Mohamad H. Tiba, Brendan M. McCracken, Robert H. Bartlett, Jake Pitcher, Robert W. Neumar, Pavel Hala, Aaron Prater, Brandon C. Cummings, Josh Jung, Stephen L Harvey, Alyssa J Enciso, Jensyn J VanZalen |
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| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | Circulation. 138 |
| ISSN: | 1524-4539 0009-7322 |
| Popis: | Introduction: The interval from cardiac arrest (CA) to initiation of chest compressions (no-flow time) plays an important role in outcome of CA. The purpose of this study was to evaluate impact of no-flow time on the effectiveness of a goal-direct CPR strategy during prolonged cardiac arrest. Hypothesis: The effectiveness of goal-directed CPR declines with increased no-flow time. Methods: Porcine model of CA was utilized with a period of untreated ventricular fibrillation of 4 or 8 min (groups CA-4, CA-8, n=5/group) followed by a goal-directed CPR protocol for up to 40 minutes. Manual and mechanical chest compressions with impedance threshold device were used sequentially to achieve PetCO2 goal >20 mmHg. Epinephrine infusion and boluses were adjusted with the goal of achieving an arterial diastolic blood pressure >35 mmHg. Hemodynamic parameters were collected throughout the protocol, averaged in 5-minute intervals and compared between groups by an unpaired t-test. Results: A higher average DBP was achieved in the CA-4 vs. CA-8 group during CPR (19 ± 11 mmHg vs. 12 ± 9 mmHg: p Conclusion: In this swine model of prolonged VF cardiac arrest, increased no-flow time limits the effectiveness of a goal-directed CPR strategy. Moreover, the response to standard dose of epinephrine was higher after shorter no-flow time. |
| Databáze: | OpenAIRE |
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