Effects of active compression-decompression cardiopulmonary resuscitation with the inspiratory threshold valve in a young porcine model of cardiac arrest.
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.
Voelckel
Wolfgang G
WG
Cardiac Arrhythmia Center, Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA. wolfgang.voelckel@uibk.ac.at
Lurie
Keith G
KG
Sweeney
Mike
M
McKnite
Scott
S
Zielinski
Todd
T
Lindstrom
Paul
P
Peterson
Colleen
C
Wenzel
Volker
V
Lindner
Karl H
KH
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