title: Influence of Chest Compressions on Circulation during the Peri-Cardiac Arrest Period in Porcine Models.
abstract: Starting chest compressions immediately after a defibrillation shock might be harmful, if the victim already had a return of spontaneous circulation (ROSC) and yet was still being subjected to external compressions at the same time. The objective of this study was to study the influence of chest compressions on circulation during the peri-cardiac arrest period.
  
  
  
  Prospective, randomized controlled study.
  
  
  
  Animal experimental center in Peking Union Medical Collage Hospital, Beijing, China.
  
  
  
  Healthy 3-month-old male domestic pigs.
  
  
  
  44 pigs (28±2 kg) were randomly assigned to three groups: Group I (non-arrested with compressions) (n = 12); Group II (arrested with compressions only) (n = 12); Group III (ROSC after compressions and defibrillation) (n = 20). In Groups I and II, compressions were performed to a depth of 5cm (Ia and IIa, n = 6) or a depth of 3cm (Ib and IIb, n = 6) respectively, while in Group III, the animals which had just achieved ROSC (n = 18) were compressed to a depth of 5cm (IIIa, n = 6), a depth of 3cm (IIIb, n = 6), or had no compressions (IIIc, n = 6). Hemodynamic parameters were collected and analyzed.
  
  
  
  Hemodynamics were statistically different between Groups Ia and Ib when different depths of compressions were performed (p < 0.05). In Group II, compressions were beneficial and hemodynamics correlated with the depth of compressions (p < 0.05). In Group III, compressions that continued after ROSC produced a reduction in arterial pressure (p < 0.05).
  
  
  
  Chest compressions might be detrimental to hemodynamics in the early post-ROSC stage. The deeper the compressions were, the better the effect on hemodynamics during cardiac arrest, but the worse the effect on hemodynamics after ROSC.
authors.affiliation: Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.affiliation: Emergency Department, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Li
authors.affiliation: Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Division of Emergency Medicine, Department of Surgery, Saint Louis University Hospital, Saint Louis, Missouri, United States of America.
authors.forename: Joseph
authors.initials: J
authors.lastname: Walline
authors.affiliation: Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Liangliang
authors.initials: L
authors.lastname: Zheng
authors.affiliation: Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yangyang
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Dongqi
authors.initials: D
authors.lastname: Yao
authors.affiliation: Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Huadong
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Emergency Department, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Xiaohe
authors.initials: X
authors.lastname: Liu
authors.affiliation: Emergency Department, Tianjin Medical University General Hospital, Tianjin, China.
authors.forename: Yanfen
authors.initials: Y
authors.lastname: Chai
authors.affiliation: Emergency Department, Beijing Tsinghua Changgung Hospital, Beijing, China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Xuezhong
authors.initials: X
authors.lastname: Yu
mesh_terms: D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004195:Disease Models, Animal; D004554:Electric Countershock; D006323:Heart Arrest / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D006336:Heart Massage / Q000379:methods*; D006439:Hemodynamics; D008297:Male; D013552:Swine; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*