Spontaneous gasping during cardiopulmonary resuscitation without mechanical ventilation.
Spontaneous gasping is frequently observed during cardiac arrest, especially when mechanical ventilation is withheld during precordial compression. We related spontaneous gasping to pulmonary gas exchange and cardiac resuscitability in a rodent model of cardiac arrest. Ventricular fibrillation was electrically induced in 15 Sprague-Dawley rats. After 4 min untreated ventricular fibrillation, precordial compression was initiated. Coronary perfusion pressure was maintained between 25 and 30 mm Hg. Oxygen was supplied at the tracheal tube port coincident with start of precordial compression in 10 animals. Five additional control animals were identically treated except they were mechanically ventilated coincident with start of precordial compression. After 6 min precordial compression, defibrillation was attempted and five of 10 nonventilated animals, and all control animals, were resuscitated by direct current countershock. In the successfully resuscitated, nonventilated animals, the frequency of spontaneous gasping during precordial compression progressively increased to an average of 19 gasps/min but it was < 6 gasps/min in nonresuscitated animals. More frequent gasping was associated with correspondingly greater arterial PO2 (110 versus 51 mm Hg, p < 0.01) and lesser PCO2 (55 versus 91 mm Hg, p < 0.01). In control animals, no spontaneous gasping was observed during precordial compression. Arterial PO2 and PCO2 of mechanically ventilated animals was more like that of spontaneously gasping rats. According, the frequency of spontaneous gasping in absence of mechanical ventilation is predictive of cardiac resuscitation success and associated with improved arterial oxygenation and CO2 removal.
Noc
M
M
Institute of Critical Care Medicine, University of Health Sciences, Chicago Medical School, Illinois.
Weil
M H
MH
Sun
S
S
Tang
W
W
Bisera
J
J
D000704:Analysis of Variance; D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data; D004195:Disease Models, Animal; D006323:Heart Arrest / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D011659:Pulmonary Gas Exchange; D051381:Rats; D017207:Rats, Sprague-Dawley; D012121:Respiration, Artificial; D015656:Respiratory Mechanics; D014693:Ventricular Fibrillation / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy