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Chest compressions versus ventilation plus chest compressions: a randomized trial in a pediatric asphyxial cardiac arrest animal model.
MedLine Citation:
PMID:  21847647     Owner:  NLM     Status:  Publisher    
PURPOSE: 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.
Marta Botran; Jesus Lopez-Herce; Javier Urbano; Maria J Solana; Ana Garcia; Angel Carrillo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-17
Journal Detail:
Title:  Intensive care medicine     Volume:  -     ISSN:  1432-1238     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, C/Doctor Castelo 47, 28009, Madrid, Spain.
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