Abstract
Objective
In contrast to the resuscitation guidelines of children and adults, guidelines on
neonatal resuscitation recommend synchronized 90 chest compressions with 30 manual
inflations (3:1) per minute in newborn infants. The study aimed to determine if chest
compression with asynchronous ventilation improves the recovery of bradycardic asphyxiated
newborn piglets compared to 3:1 Compression:Ventilation cardiopulmonary resuscitation
(CPR).
Intervention and measurements
Term newborn piglets (n = 8/group) were anesthetized, intubated, instrumented and exposed to 45-min normocapnic
hypoxia followed by asphyxia. Protocolized resuscitation was initiated when heart
rate decreased to 25% of baseline. Piglets were randomized to receive resuscitation
with either 3:1 compressions to ventilations (3:1 C:V CPR group) or chest compressions with asynchronous ventilations (CCaV) or sham.
Continuous respiratory parameters (Respironics NM3®), cardiac output, mean systemic and pulmonary artery pressures, and regional blood
flows were measured.
Main results
Piglets in 3:1 C:V CPR and CCaV CPR groups had similar time to return of spontaneous circulation,
survival rates, hemodynamic and respiratory parameters during CPR. The systemic and
regional hemodynamic recovery in the subsequent 4 h was similar in both groups and significantly lower compared to sham-operated piglets.
Conclusion
Newborn piglets resuscitated by CCaV had similar return of spontaneous circulation,
survival, and hemodynamic recovery compared to those piglets resuscitated by 3:1 Compression:Ventilation
ratio.
Abbreviations:
CC (chest compressions), CPR (cardiopulmonary resuscitation), ROSC (return of spontaneous circulation), CCaV (continuous chest compression with asynchronous ventilation), C:V (Compression:Ventilation), MAP (mean arterial pressure), PAP (pulmonary artery pressure), CVP (central venous pressure), SMA (superior mesenteric artery), PA (pulmonary artery), VT (tidal volume), ECO2 (exhaled CO2)Keywords
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Article info
Publication history
Published online: October 24, 2013
Accepted:
October 11,
2013
Received in revised form:
October 1,
2013
Received:
July 3,
2013
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2013.10.011.
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
