title: Effects of active compression-decompression cardiopulmonary resuscitation with the inspiratory threshold valve in a young porcine model of cardiac arrest.
abstract: Active compression-decompression (ACD) cardiopulmonary resuscitation (CPR) with the inspiratory threshold valve (ITV) has been recently recommended by the American Heart Association for treatment of adults in cardiac arrest (class IIb: alternative, useful intervention), but this new technique has never been used in a pediatric population. Thus, this study was designed to evaluate ACD + ITV CPR in a young porcine model of cardiac arrest. After 10 min of ventricular fibrillation, and 8 min of standard CPR, ACD + ITV CPR was performed in seven 4- to 6-wk-old pigs (8-12 kg); defibrillation was attempted 8 min later. Within 2 min after initiation of ACD + ITV CPR, mean (+/- SEM) coronary perfusion pressure increased from 18 +/- 2 to 24 +/- 3 mm Hg (p = 0.018). During standard versus ACD + ITV CPR, mean left ventricular myocardial and total cerebral blood flow was 59 +/- 21 versus 126 +/- 32 mL.min(-1).100 g(-1), and 36 +/- 7 versus 60 +/- 15 mL.min(-1).100 g(-1), respectively (p = 0.028). Six of seven animals were successfully defibrillated, and survived >15 min. In conclusion, the combination of ACD + ITV CPR significantly increased both coronary perfusion pressure and vital organ blood flow after prolonged standard CPR in this young porcine model of ventricular fibrillation.
authors.affiliation: Cardiac Arrhythmia Center, Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA. wolfgang.voelckel@uibk.ac.at
authors.forename: Wolfgang G
authors.initials: WG
authors.lastname: Voelckel
authors.forename: Keith G
authors.initials: KG
authors.lastname: Lurie
authors.forename: Mike
authors.initials: M
authors.lastname: Sweeney
authors.forename: Scott
authors.initials: S
authors.lastname: McKnite
authors.forename: Todd
authors.initials: T
authors.lastname: Zielinski
authors.forename: Paul
authors.initials: P
authors.lastname: Lindstrom
authors.forename: Colleen
authors.initials: C
authors.lastname: Peterson
authors.forename: Volker
authors.initials: V
authors.lastname: Wenzel
authors.forename: Karl H
authors.initials: KH
authors.lastname: Lindner
mesh_terms: D000328:Adult; D000818:Animals; D001775:Blood Circulation; D001784:Blood Gas Analysis; D001794:Blood Pressure; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation / Q000379:methods; D004195:Disease Models, Animal; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D013552:Swine