Single Ventilation during Cardiopulmonary Resuscitation Results in Better Neurological Outcomes in a Porcine Model of Cardiac Arrest
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Purpose: Recent basic life support (BLS) guidelines recommend a 30:2 compression-to-ventilation ratio (CV2) or chest compression-only cardiopulmonary resuscitation (CC); however, there are inevitable risks of interruption of high-quality cardiopulmonaryresuscitation (CPR) in CV2 and hypoxemia in CC. In this study, we compared the short-term outcomes among CC, CV2, and30:1 CV ratio (CV1). Materials and Methods: In total, 42 pigs were randomly assigned to CC, CV1, or CV2 groups. After induction of ventricular fibrillation(VF), we observed pigs for 2 minutes without any intervention. Thereafter, BLS was started according to the assigned methodand performed for 8 minutes. Defibrillation was performed after BLS and repeated every 2 minutes, followed by rhythm analysis. Advanced cardiac life support, including continuous chest compression with ventilation every 6 seconds and intravenousinjection of 1 mg epinephrine every 4 minutes, was performed until the return of spontaneous circulation (ROSC) or 22 minutesafter VF induction. Hemodynamic parameters and arterial blood gas profiles were compared among groups. ROSC, 24-hour survival,and neurologic outcomes were evaluated at 24 hours. Results: The hemodynamic parameters during CPR did not differ among the study groups. Partial pressure of oxygen in arterialblood and arterial oxygen saturation were lowest in the CC group, compared to those in the other groups, during the BLS period(p=0.002 and p<0.001, respectively). The CV1 groups showed a significantly higher rate of favorable neurologic outcome (swineCPC 1 or 2) than the other groups (p=0.044). Conclusion: CPR with CV1 could promote better neurologic outcome than CV2 and CC.
Abstract
Purpose: Recent basic life support (BLS) guidelines recommend a 30:2 compression-to-ventilation ratio (CV2) or chest compression-only cardiopulmonary resuscitation (CC); however, there are inevitable risks of interruption of high-quality cardiopulmonaryresuscitation (CPR) in CV2 and hypoxemia in CC. In this study, we compared the short-term outcomes among CC, CV2, and30:1 CV ratio (CV1). Materials and Methods: In total, 42 pigs were randomly assigned to CC, CV1, or CV2 groups. After induction of ventricular fibrillation(VF), we observed pigs for 2 minutes without any intervention. Thereafter, BLS was started according to the assigned methodand performed for 8 minutes. Defibrillation was performed after BLS and repeated every 2 minutes, followed by rhythm analysis. Advanced cardiac life support, including continuous chest compression with ventilation every 6 seconds and intravenousinjection of 1 mg epinephrine every 4 minutes, was performed until the return of spontaneous circulation (ROSC) or 22 minutesafter VF induction. Hemodynamic parameters and arterial blood gas profiles were compared among groups. ROSC, 24-hour survival,and neurologic outcomes were evaluated at 24 hours. Results: The hemodynamic parameters during CPR did not differ among the study groups. Partial pressure of oxygen in arterialblood and arterial oxygen saturation were lowest in the CC group, compared to those in the other groups, during the BLS period(p=0.002 and p<0.001, respectively). The CV1 groups showed a significantly higher rate of favorable neurologic outcome (swineCPC 1 or 2) than the other groups (p=0.044). Conclusion: CPR with CV1 could promote better neurologic outcome than CV2 and CC.
참고문헌 (28)
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