title: Chest compressions versus ventilation plus chest compressions: a randomized trial in a pediatric asphyxial cardiac arrest animal model.
abstract: OBJECTIVE
  To compare survival, oxygenation, ventilation, and hemodynamic variables achieved with chest compressions or ventilation plus chest compressions.
  
  
  METHODS
  This randomized experimental study was conducted in the experimental department of a university hospital. Thirty infant pigs with asphyxial cardiac arrest were randomized into two groups of cardiopulmonary resuscitation (CPR): group 1, continuous chest compressions plus non-coordinated ventilation with a mask and mechanical ventilator (inspired oxygen fraction 0.21) (VC); group 2, chest compressions only (CC). Nine minutes of basic resuscitation was performed initially in both groups, followed by advanced resuscitation. CPR was terminated on achieving return of spontaneous circulation (ROSC) or after 30 min of total resuscitation time without ROSC.
  
  
  RESULTS
  Three animals (18.8%) in the VC group and 1 (7.1%) in the CC group achieved ROSC (P = 0.351). Oxygenation and ventilation during basic CPR were insufficient in both groups, though they were significantly better in the VC group than in the CC group after 9 min (PaO(2), 26 vs. 19 mmHg, P = 0.008; PaCO(2), 84 vs. 101 mmHg, P = 0.05). Cerebral saturation was higher in the VC group (61%) than in the CC group (30%) (P = 0.06). There were no significant differences in mean arterial pressure.
  
  
  CONCLUSIONS
  Neither of the basic CPR protocols achieved adequate oxygenation and ventilation in this model of asphyxial pediatric cardiac arrest. Chest compressions plus ventilation produced better oxygenation, ventilation, and cerebral oxygenation with no negative hemodynamic effects. Survival was higher in the VC group, though the difference was not statistically significant.
authors.affiliation: Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, C/Doctor Castelo 47, 28009, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Botran
authors.forename: Jesus
authors.initials: J
authors.lastname: Lopez-Herce
authors.forename: Javier
authors.initials: J
authors.lastname: Urbano
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Solana
authors.forename: Ana
authors.initials: A
authors.lastname: Garcia
authors.forename: Angel
authors.initials: A
authors.lastname: Carrillo
mesh_terms: D000818:Animals; D001237:Asphyxia / Q000150:complications*; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003131:Combined Modality Therapy; D006323:Heart Arrest / Q000628:therapy*; D023421:Models, Animal; D010101:Oxygen Consumption / Q000502:physiology; D011897:Random Allocation; D012121:Respiration, Artificial; D013030:Spain; D016019:Survival Analysis; D013552:Swine