| Delayed onset of cardiac compressions in cardiopulmonary resuscitation of newborn pigs with asphyctic cardiac arrest. | |
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MedLine Citation:
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PMID: 20829634 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background: When 30 s of initial positive pressure ventilation fails to stabilize the heart rate (HR) of newborns in the delivery room, the International Liaison Committee on Resuscitation guidelines recommend initiation of cardiac compressions. However, it may take longer than 30 s to establish effective pulmonary gas exchange. Whether a longer period of initial ventilation to reverse asphyxia would result in less need for cardiac compressions is unknown. Objectives: Our purpose was to investigate the effect of three different initial ventilation intervals prior to initiation of cardiac compressions on hemodynamic parameters, arterial blood gases, oxygen saturations and markers of inflammation and hypoxic damage in a piglet model of asystole due to asphyxia. Methods: Noroc piglets were anesthetized and mechanically ventilated. Progressive asphyxia was induced until asystole occurred. Randomization was made to ventilation with 21% O(2) for (1) 30 s (n = 16), (2) 1 min (n = 16), or (3) 1.5 min (n = 8) before initiation of cardiac compressions. Return of spontaneous circulation (ROSC) was defined as HR ≥100 min(-1). Results: Piglets initially ventilated for 30 s and 1 and 1.5 min achieved ROSC in a median of 150 (interquartile range 115-180),163 (124-177) and 282 (199-364) s, respectively. p value for group 1 versus group 2 was 0.51 and <0.001 for group 1 versus group 3. There were no differences in temporal changes in oxygen saturations, mean arterial blood pressure, HR, pH, pCO(2), interleukin-1β or lactate/pyruvate ratios between groups. Conclusion: Although an additional 30 s to ensure effective ventilation does not impair the speed or success in achieving ROSC, delaying circulatory support for as long as 1.5 min of initial ventilation may be harmful. |
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Authors:
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Ingrid Dannevig; Anne L Solevåg; Myra Wyckoff; Ola D Saugstad; Britt Nakstad |
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Publication Detail:
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Type: Journal Article Date: 2010-09-11 |
Journal Detail:
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Title: Neonatology Volume: 99 ISSN: 1661-7819 ISO Abbreviation: Neonatology Publication Date: 2011 |
Date Detail:
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Created Date: 2011-02-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101286577 Medline TA: Neonatology Country: Switzerland |
Other Details:
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Languages: eng Pagination: 153-62 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 S. Karger AG, Basel. |
Affiliation:
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Department of Pediatrics, Akershus University Hospital, Lørenskog, Norway. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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