Document Detail


Effect of rescue breathing during cardiopulmonary resuscitation on lung function after restoration of spontaneous circulation in a porcine model of prolonged cardiac arrest.
MedLine Citation:
PMID:  23269128     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The destruction of the pulmonary structure after cardiopulmonary resuscitation may lead to lung function breakdown. The aim of this study was to investigate lung function after cardiopulmonary resuscitation and the influence of rescue breathing on lung function.
DESIGN: Prospective, randomized animal study.
SETTING: A university animal research laboratory.
SUBJECTS: Twenty-eight male domestic pigs weighing 30 ± 2 kg.
INTERVENTIONS: The animals were randomized into three groups: continuous compressions (n = 12), 30:2 compression/rescue ventilation cardiopulmonary resuscitation (n = 12), and sham cardiopulmonary resuscitation (n = 4). Ventricular fibrillation was induced in the continuous compressions and compression/rescue ventilation groups.
MEASUREMENTS AND MAIN RESULTS: Cardiac output, extravascular lung water, and airway resistance were measured at baseline and 1, 2, and 4 hrs after restoration of spontaneous circulation. Thoracopulmonary compliance, lower inflection point, and dead space were calculated. Lung ventilation/perfusion scans with Tc were performed 48 hrs before the experiment and 24 hrs after restoration of spontaneous circulation. Conventional histopathology evaluation was performed. Dead space, airway resistance, lower inflection point, and extravascular lung water significantly increased and compliance decreased after restoration of spontaneous circulation in the continuous compressions and compression/rescue ventilation groups. Lung injury was more severe in the continuous compressions group. Significant differences were found between the two groups in the three time points after restoration of spontaneous circulation (p < 0.05). Variables of the sham cardiopulmonary resuscitation group remained stable during the whole protocol. Poor ventilation/perfusion and mismatch were found after restoration of spontaneous circulation, but the injury was mitigated in the compression/rescue ventilation group. Histopathology injury in the compression/rescue ventilation group was also improved.
CONCLUSIONS: Appropriate rescue breathing during cardiopulmonary resuscitation does not influence the prognosis of cardiac arrest or the hemodynamics after restoration of spontaneous circulation but can improve lung function and alleviate lung injury.
Authors:
Shuo Wang; Jun-Yuan Wu; Zhi-Jun Guo; Chun-Sheng Li
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  41     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-27     Completed Date:  2013-03-04     Revised Date:  2013-07-02    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  102-10     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Chaoyang District, Beijing, China.
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MeSH Terms
Descriptor/Qualifier:
Acute Lung Injury / etiology,  prevention & control*
Animals
Cardiopulmonary Resuscitation / adverse effects,  methods*
Heart Arrest / therapy*
Hemodynamics
Male
Positive-Pressure Respiration*
Prospective Studies
Random Allocation
Respiratory Function Tests
Swine
Comments/Corrections
Comment In:
Crit Care Med. 2013 Jun;41(6):e100   [PMID:  23685592 ]
Crit Care Med. 2013 Jun;41(6):e99-100   [PMID:  23685606 ]
Crit Care Med. 2013 Jan;41(1):346-8   [PMID:  23269144 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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