title: Assisted ventilation does not improve outcome in a porcine model of single-rescuer bystander cardiopulmonary resuscitation.
abstract: BACKGROUND
  Mouth-to-mouth rescue breathing is a barrier to the performance of bystander cardiopulmonary resuscitation (CPR). We evaluated the need for assisted ventilation during simulated single-rescuer bystander CPR in a swine model of prehospital cardiac arrest.
  
  
  RESULTS
  Five minutes after ventricular fibrillation, swine were randomly assigned to 8 minutes of hand-bag-valve ventilation with 17% oxygen and 4% carbon dioxide plus chest compressions (CC + V), chest compressions only (CC), or no CPR (control group). Standard advanced life support was then provided. Animals successfully resuscitated received 1 hour of intensive care support and were observed for 24 hours. All 10 CC animals, 9 of the 10 CC + V animals, and 4 of the 6 control animals attained return of spontaneous circulation. Five of the 10 CC animals, 6 of the 10 CC + V animals, and none of the 6 control animals survived for 24 hours (CC versus controls, P = .058; CC + V versus controls, P < .03). All 24-hour survivors were normal or nearly normal neurologically.
  
  
  CONCLUSIONS
  In this model of prehospital single-rescuer bystander CPR, successful initial resuscitation, 24-hour survival, and neurological outcome were similar after chest compressions only or chest compressions plus assisted ventilation. Both techniques tended to improve outcome compared with no bystander CPR.
authors.affiliation: Department of Pediatrics, Steele Memorial Children's Research Center, Tucson, Ariz, USA. rberg@aruba.ccit.arizona.edu
authors.forename: R A
authors.initials: RA
authors.lastname: Berg
authors.forename: K B
authors.initials: KB
authors.lastname: Kern
authors.forename: R W
authors.initials: RW
authors.lastname: Hilwig
authors.forename: M D
authors.initials: MD
authors.lastname: Berg
authors.forename: A B
authors.initials: AB
authors.lastname: Sanders
authors.forename: C W
authors.initials: CW
authors.lastname: Otto
authors.forename: G A
authors.initials: GA
authors.lastname: Ewy
mesh_terms: D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005069:Evaluation Studies as Topic; D009420:Nervous System / Q000503:physiopathology; D011312:Pressure; D012121:Respiration, Artificial; D016019:Survival Analysis; D013552:Swine; D013909:Thorax