Ventilatory effects of active compression-decompression in dogs.
OBJECTIVE
To determine the ventilatory effect of active compression-decompression CPR and to compare it with two other techniques, standard manual cardiac massage and mechanical cardiac massage.


METHODS
Prospective, randomized laboratory investigation.


METHODS
Mongrel dogs.


METHODS
Nine adult mongrel dogs were anesthetized, intubated, and mechanically ventilated. They were instrumented to measure arterial pressure, esophageal pressure, airway pressure, end-tidal carbon dioxide concentration, and minute ventilation.


RESULTS
After induction of ventricular fibrillation, three sequences of cardiac massage were performed randomly during mechanical ventilation, standard cardiac massage, mechanical cardiac massage, and active compression-decompression technique. The animals then were disconnected from the ventilator, and the three sequences were performed again. Active compression-decompression created negative minimum esophageal pressures and significantly decreased the minimum airway pressure as compared with the other techniques. Whatever the ventilatory condition, minute ventilation was increased dramatically during active compression-decompression.


CONCLUSIONS
In this model of cardiac arrest, an important increase in minute ventilation was observed during active compression-decompression. This effect was significantly greater than the increases observed with other techniques of cardiac massage and was related to the negative pressure generated by active decompression.
Carli
P A
PA
Department of Anesthesiology and Critical Care, Hopital Necker, SAMU de Paris, France.
De La Coussaye
J E
JE
Riou
B
B
Sassine
A
A
Eledjam
J J
JJ
D000403:Airway Resistance; D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004195:Disease Models, Animal; D004285:Dogs; D005069:Evaluation Studies as Topic; D005260:Female; D006336:Heart Massage / Q000379:methods*; D008297:Male; D011312:Pressure; D011897:Random Allocation; D012121:Respiration, Artificial / Q000379:methods*; D015656:Respiratory Mechanics; D014693:Ventricular Fibrillation / Q000503:physiopathology / Q000628:therapy*