Cardiopulmonary Resuscitation With Chest Compressions During Sustained Inflations
| Autor: | Shaun Cowan, Joseph LaBossiere, Georg M. Schmölzer, Sharon Qin, Tze-Fun Lee, Megan O'Reilly, Po-Yin Cheung, David L. Bigam |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Resuscitation
Time Factors Swine medicine.medical_treatment Return of spontaneous circulation Asphyxia Random Allocation Physiology (medical) Heart rate Animals Medicine Cardiopulmonary resuscitation Chest wall oscillation business.industry Insufflation Recovery of Function Hypoxia (medical) Cardiopulmonary Resuscitation Chest Wall Oscillation Heart Arrest Survival Rate Disease Models Animal Animals Newborn Anesthesia medicine.symptom Cardiology and Cardiovascular Medicine business Neonatal resuscitation |
| Zdroj: | Circulation. 128:2495-2503 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/circulationaha.113.002289 |
| Popis: | Background— Guidelines on neonatal resuscitation recommend 90 chest compressions (CCs) and 30 manual inflations (3:1) per minute in newborns. The study aimed to determine whether CC s during sustained inflations (SIs) improves the recovery of asphyxiated newborn piglets in comparison with coordinated 3:1 resuscitation. Methods and Results— Term newborn piglets (n=8/group) were anesthetized, intubated, instrumented, and exposed to 45-minute normocapnic hypoxia followed by asphyxia. Piglets were randomly assigned to receive either 3:1 resuscitation (3:1 group) or CCs during SIs (SI group) when the heart rate decreased to 25% of baseline. Piglets randomly assigned to the SI group received SIs with a pressure of 30 cm H 2 O for 30 s. During the SI, CCs at a rate of 120/min were provided. SI was interrupted after 30 s for 1 s before a further 30-s SI was provided. CCs were continued throughout SIs. CCs and SI were continued until the return of spontaneous circulation. Continuous respiratory parameters, cardiac output, mean systemic and pulmonary artery pressures, and regional blood flows were measured. Mean (standard deviation) time for return of spontaneous circulation was significantly reduced in SI group versus 3:1 group (32 [11] s versus 205 [113] s, respectively). In the SI group, administration of oxygen and epinephrine was significantly lower, whereas minute ventilation and exhaled CO 2 were significantly increased. The SI group had significantly higher mean systemic and pulmonary arterial pressures during resuscitation in comparison with the 3:1 group (51 [10] versus 31 [5] mm Hg; 41[7] versus 31 [7] mm Hg, respectively; all P Conclusions— Combining CCs and SIs significantly improved the return of spontaneous circulation with better hemodynamic recovery in asphyxiated newborn piglets in comparison with standard coordinated 3:1 resuscitation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|