title: The influence of hemorrhagic shock on ventilation through needle cricothyroidotomy in pigs.
abstract: BACKGROUND
  The aim of this study was to examine the effects of controlled hemorrhage and shock on oxygenation and ventilation using needle cricothyroidotomy and jet ventilation in an animal model.
  
  
  METHODS
  Twenty-four male pigs were randomly allocated into 4 groups: SHOCK (animals in hemorrhagic shock only), CRICH (animals that underwent needle cricothyroidotomy only), SHOCK+CRICH (animals in hemorrhagic shock + needle cricothyroidotomy), and SHAM (anesthetized animals submitted to surgical preparation only). All animals were surgically prepared and were observed for a period of 40 minutes (T0 - T40). Hemodynamic and blood gas variables were compared using analysis of variance and Bonferroni post hoc testing at a level of significance of 95%.
  
  
  RESULTS
  CRICH and SHOCK+CRICH developed respiratory acidosis, with a progressive decrease of arterial pH after T20, and they presented a significant increase of PaCO(2) levels after T10, when compared with SHAM and SHOCK (P < .001). When SHOCK+CRICH was compared with CRICH, it presented a larger increase of PaCO(2) after T10 (P = .036) and an even more significant increase after T20 (P = .009).
  
  
  CONCLUSIONS
  Hemorrhagic shock anticipated and intensified the retention of carbon dioxide and respiratory acidosis during manual jet ventilation through needle cricothyroidotomy in comparison with animals with jet ventilation but without shock. The results found in this work should be considered in future protocols for the assistance of victims of trauma in prehospital settings.
authors.affiliation: Surgery Department, Paulista School of Medicine, Federal University of São Paulo, PR, Brazil. muradivan@yahoo.com.br
authors.forename: Ivan
authors.initials: I
authors.lastname: Murad
authors.forename: Simone C V
authors.initials: SC
authors.lastname: Abib
authors.forename: Daniela P A
authors.initials: DP
authors.lastname: Lima
authors.forename: Paulo S V S
authors.initials: PS
authors.lastname: Ferreira
authors.forename: Eduardo Q
authors.initials: EQ
authors.lastname: dos Santos
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Bataglia
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D002245:Carbon Dioxide / Q000097:blood; D002302:Cardiac Output / Q000502:physiology; D003413:Cricoid Cartilage / Q000601:surgery; D006611:High-Frequency Jet Ventilation; D008297:Male; D009339:Needles; D010100:Oxygen / Q000097:blood; D011651:Pulmonary Artery / Q000502:physiology; D012771:Shock, Hemorrhagic / Q000503:physiopathology*; D013552:Swine; D014140:Tracheotomy
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen