Preview
Abstract
BACKGROUND
The rationale for a compression to ventilation ratio of 3:1 in neonates with primary hypoxic, hypercapnic cardiac arrest is to emphasize the importance of ventilation; however, there are no published studies testing this approach against alternative methods.
OBJECTIVES
To evaluate if using a 2:1 C:V ratio or a 4:1 C:V ratio will improve ROSC compared to using a 3:1 C:V ratio.
DESIGN/METHODS
Term newborn piglets were anesthetized, intubated, instrumented, and exposed to 40-min normocapnic hypoxia followed by asphyxia. Asphyxia was achieved by clamping the endotracheal tube until the piglet had asystole; at that time CPR was initiated. Piglets were then randomized into 3 groups: 2:1 C:V ratio (n=8), 3:1 ratio (n=8), 4:1 C:V ratio (n=8), or a sham operated group. A two-step randomization was used to reduce selection bias. After surgical instrumentation and stabilization, a sequentially numbered, sealed brown envelope containing the allocation “sham” or “intervention” was opened (step one). The sham-operated group had the same surgical protocol, stabilization, and equivalent experimental periods without hypoxia and asphyxia. Only piglets randomized to “intervention” underwent hypoxia and asphyxia. Once the criteria for CPR were met, a second envelope containing the allocations “2:1”,“3:1”,or “4:1”, was opened (step two). Cardiac function, carotid blood flow, cerebral oxygenation, and respiratory parameters were continuously recorded throughout the experiment.
RESULTS
The median (IQR) duration of asphyxia was similar between the groups with 318 (194–576)sec, 255 (226–334)sec, 233 (169–395)sec for 2:1, 3:1, 4:1 C:V, respectively (p=0.68; oneway ANOVA with Bonferroni). The median (IQR) time to ROSC was also similar between groups 127 (82–210)sec, 96 (88–126)sec, 119 (83–256)sec for 2:1, 3:1, 4:1 C:V, respectively (p=0.67; oneway ANOVA with Bonferroni). Overall, 8/8 in the 2:1 C:V ratio group, 7/8 in the 3:1 C:V ratio group, and 7/8 in the 4:1 C:V ratio group survived.
CONCLUSION
There was no significant difference in time to ROSC for either chest compression technique during cardiopulmonary resuscitation in a porcine model of neonatal asphyxia.
Journal Article. 0 words.
Subjects: Neonatology ; Primary Care ; Child and Adolescent Psychiatry ; Clinical Child and Adolescent Psychology ; Developmental Psychology
Full text: subscription required
How to subscribe Recommend to my Librarian
Users without a subscription are not able to see the full content. Please, subscribe or login to access all content. subscribe or login to access all content.
