title: Risk factor analyses for the return of spontaneous circulation in the asphyxiation cardiac arrest porcine model.
abstract: BACKGROUND
  Animal models of asphyxiation cardiac arrest (ACA) are frequently used in basic research to mirror the clinical course of cardiac arrest (CA). The rates of the return of spontaneous circulation (ROSC) in ACA animal models are lower than those from studies that have utilized ventricular fibrillation (VF) animal models. The purpose of this study was to characterize the factors associated with the ROSC in the ACA porcine model.
  
  
  METHODS
  Forty-eight healthy miniature pigs underwent endotracheal tube clamping to induce CA. Once induced, CA was maintained untreated for a period of 8 min. Two minutes following the initiation of cardiopulmonary resuscitation (CPR), defibrillation was attempted until ROSC was achieved or the animal died. To assess the factors associated with ROSC in this CA model, logistic regression analyses were performed to analyze gender, the time of preparation, the amplitude spectrum area (AMSA) from the beginning of CPR and the pH at the beginning of CPR. A receiver-operating characteristic (ROC) curve was used to evaluate the predictive value of AMSA for ROSC.
  
  
  RESULTS
  ROSC was only 52.1% successful in this ACA porcine model. The multivariate logistic regression analyses revealed that ROSC significantly depended on the time of preparation, AMSA at the beginning of CPR and pH at the beginning of CPR. The area under the ROC curve in for AMSA at the beginning of CPR was 0.878 successful in predicting ROSC (95% confidence intervals: 0.773∼0.983), and the optimum cut-off value was 15.62 (specificity 95.7% and sensitivity 80.0%).
  
  
  CONCLUSIONS
  The time of preparation, AMSA and the pH at the beginning of CPR were associated with ROSC in this ACA porcine model. AMSA also predicted the likelihood of ROSC in this ACA animal model.
authors.forename: Cai-Jun
authors.initials: CJ
authors.lastname: Wu
authors.forename: Zhi-Jun
authors.initials: ZJ
authors.lastname: Guo
authors.affiliation: Department of Emergency, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
authors.forename: Chun-Sheng
authors.initials: CS
authors.lastname: Li
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
mesh_terms: D000818:Animals; D016887:Cardiopulmonary Resuscitation; D006323:Heart Arrest / Q000503:physiopathology*; D016015:Logistic Models; D013552:Swine