title: Nasopharyngeal oxygen with intermittent nose-close and abdomen-compression: a novel resuscitation technique in a piglet model.
abstract: OBJECTIVE
  To evaluate the efficacy of a simple and novel cardiopulmonary resuscitation (CPR) technique, nasopharyngeal oxygen with intermittent nose-close and abdomen-compression (NPO(2) -NC-AC) in an animal model.
  
  
  METHODS
  Prospective piglet study.
  
  
  METHODS
  In an animal physiology laboratory of a medical university. PIGLETS: Six healthy piglets <14 days old.
  
  
  METHODS
  Spontaneous breathing of the anesthetized piglets (n = 6) was medically ceased until severe bradycardia (<20 beat/min). NPO(2) -NC-AC CPR trial was then initiated by delivering NPO(2) at 1.0-1.5 L/kg/min and intermittently performing the NC-AC maneuver: (1) NC for inspiration, occluded nostrils for 1 sec; and (2) AC for expiration, released nostrils, and compressed the abdomen for 1 sec. NC-AC was repeated at a rate of 30/min for 5 min. This CPR trial was repeated three times in each piglet. Cardiopulmonary variables were monitored, recorded, and compared.
  
  
  RESULTS
  A total of 18 CPR trials were performed. All of these acute life-threatening asphyxia events rapidly improved within 1 min of CPR. Cardiopulmonary variables recovered to the baseline levels and oxygenation continually increased. The intratracheal pressure (P(tr) ) values of positive end expiratory pressure and peak inspiratory pressure values were 4.3 ± 0.8 cmH(2) O and 26.2 ± 4.1 cmH(2) O, respectively. Chest wall movement was observed when the P(tr) reached 17.5 ± 3.1 cmH(2) O. All six piglets fully recovered after 63.8 ± 7.2 min of experiment without additional support.
  
  
  CONCLUSIONS
  NPO(2) -NC-AC is a simple and effective CPR technique for severe acute cardiopulmonary asphyxia in piglets. It may be clinically applicable for supportive or rescue use.
authors.affiliation: Department of Pediatrics, Children's Medical Center, Taipei Veterans General Hospital, Taipei, Taiwan. wjsoong@vghtpe.gov.tw
authors.forename: Wen-Jue
authors.initials: WJ
authors.lastname: Soong
authors.forename: Mei-Jy
authors.initials: MJ
authors.lastname: Jeng
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Lee
authors.forename: Pei-Chen
authors.initials: PC
authors.lastname: Tsao
authors.forename: Yen-Hui Matthew
authors.initials: YH
authors.lastname: Soong
mesh_terms: D000005:Abdomen; D000818:Animals; D001237:Asphyxia / Q000628:therapy*; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D007440:Intubation; D009296:Nasal Cavity; D010100:Oxygen / Q000008:administration & dosage*; D010614:Pharynx; D012121:Respiration, Artificial / Q000379:methods*; D013552:Swine; D016896:Treatment Outcome
chemical_list: D010100:Oxygen