Chest compressions versus ventilation plus chest compressions in a pediatric asphyxial cardiac arrest animal model.

摘要

OBJECTIVE: To compare the ventilation achieved with chest compressions (CC) or ventilation plus compressions (VC) in a pediatric animal model of cardiac arrest. DESIGN: Randomized experimental study. SETTING: Experimental department of a University Hospital. METHODS: Twelve infant pigs with asphyxial cardiac arrest. Sequential 3-min periods of VC and CC were performed for a total duration of 9 min. Tidal volume (TV), end-tidal CO(2) (EtCO(2)), mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary arterial pressure (mPAP), and peripheral, cerebral, and renal saturations were recorded and arterial and venous blood gases were analyzed. RESULTS: VC achieved a TV similar to the preset parameters on the ventilator, whilst the TV in CC was very low (P < 0.001). EtCO(2) with VC was significantly higher than with CC (14.0 vs. 3.9 mmHg, P < 0.05). Arterial pH was higher with VC than with CC (6.99 vs. 6.90 mmHg, P < 0.05). Arterial PCO(2) was lower with VC than with CC (62.1 vs. 97.0 mmHg, P < 0.05). There were no significant differences in the MAP; CVP; mPAP; peripheral, renal, and cerebral saturations; or lactate concentrations between the two techniques. CONCLUSIONS: VC achieves better ventilation than CC during cardiopulmonary resuscitation and has no negative effect on the hemodynamic situation.