Effects of stomach inflation on haemodynamic and pulmonary function during cardiopulmonary resuscitation in pigs.
OBJECTIVE
Stomach inflation during cardiopulmonary resuscitation (CPR) is frequent, but the effect on haemodynamic and pulmonary function is unclear. The purpose of this study was to evaluate the effect of clinically realistic stomach inflation on haemodynamic and pulmonary function during CPR in a porcine model.


METHODS
After baseline measurements ventricular fibrillation was induced in 21 pigs, and the stomach was inflated with 0L (n=7), 5L (n=7) or 10L air (n=7) before initiating CPR.


RESULTS
During CPR, 0, 5, and 10L stomach inflation resulted in higher mean pulmonary artery pressure [median (min-max)] [35 (28-40), 47 (25-50), and 51 (49-75) mmHg; P<0.05], but comparable coronary perfusion pressure [10 (2-20), 8 (4-35) and 5 (2-13) mmHg; P=0.54]. Increasing (0, 5, and 10L) stomach inflation decreased static pulmonary compliance [52 (38-98), 19 (8-32), and 12 (7-15) mL/cmH(2)O; P<0.05], and increased peak airway pressure [33 (27-36), 53 (45-104), and 103 (96-110) cmH(2)O; P<0.05). Arterial oxygen partial pressure was higher with 0L when compared with 5 and 10L stomach inflation [378 (88-440), 58 (47-113), and 54 (43-126) mmHg; P<0.05). Arterial carbon dioxide partial pressure was lower with 0L when compared with 5 and 10L stomach inflation [30 (24-36), 41(34-51), and 56 (45-68) mmHg; P<0.05]. Return of spontaneous circulation was comparable between groups (5/7 in 0L, 4/7 in 5L, and 3/7 in 10L stomach inflation; P=0.56).


CONCLUSIONS
Increasing levels of stomach inflation had adverse effects on haemodynamic and pulmonary function, indicating an acute abdominal compartment syndrome in this CPR model.
Paal
Peter
P
Department of Anesthesiology and General Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria. peter.paal@uki.at
Neurauter
Andreas
A
Loedl
Michael
M
Pehböck
Daniel
D
Herff
Holger
H
von Goedecke
Achim
A
Lindner
Karl H
KH
Wenzel
Volker
V
D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002404:Catheterization / Q000379:methods*; D004195:Disease Models, Animal; D005260:Female; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics / Q000502:physiology*; D008168:Lung / Q000503:physiopathology*; D008297:Male; D012129:Respiratory Function Tests; D013270:Stomach; D013552:Swine; D016896:Treatment Outcome