| End-tidal CO₂ detection of an audible heart rate during neonatal cardiopulmonary resuscitation after asystole in asphyxiated piglets. | |
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MedLine Citation:
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PMID: 21283051 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Even brief interruption of cardiac compressions significantly reduces critical coronary perfusion pressure during cardiopulmonary resuscitation (CPR). End-tidal CO₂ (ETCO₂) monitoring may provide a continuous noninvasive method of assessing return of spontaneous circulation (ROSC) without stopping to auscultate for heart rate (HR). However, the ETCO₂ value that correlates with an audible HR is unknown. Our objective was to determine the threshold ETCO₂ that is associated with ROSC after asphyxia-induced asystole. Neonatal swine (n = 46) were progressively asphyxiated until asystole occurred. Resuscitation followed current neonatal guidelines with initial ventilation with 100% O₂ followed by cardiac compressions followed by epinephrine for continued asystole. HR was auscultated every 30 s, and ETCO₂ was continuously recorded. A receiver operator curve was generated using the calculated sensitivity and specificity for various ETCO₂ values, where a positive test was defined as the presence of HR >60 bpm by auscultation. An ETCO₂ cut-off value of 14 mm Hg is the most sensitive ETCO₂ value with the least false positives. When using ETCO₂ to guide uninterrupted CPR in this model of asphyxia-induced asystole, auscultative confirmation of return of an adequate HR should be performed when ETCO₂ ≥ 14 mm Hg is achieved. Correlation during human neonatal CPR needs further investigation. |
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Authors:
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Lina F Chalak; Chad A Barber; Linda Hynan; Damian Garcia; Lucy Christie; Myra H Wyckoff |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pediatric research Volume: 69 ISSN: 1530-0447 ISO Abbreviation: Pediatr. Res. Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-15 Completed Date: 2011-07-25 Revised Date: 2012-05-02 |
Medline Journal Info:
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Nlm Unique ID: 0100714 Medline TA: Pediatr Res Country: United States |
Other Details:
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Languages: eng Pagination: 401-5 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA. lina.chalak@utsouthwestern.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic Agonists
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administration & dosage Animals Animals, Newborn Asphyxia Neonatorum / complications*, metabolism, physiopathology Biological Markers / metabolism Blood Pressure Breath Tests* Carbon Dioxide / metabolism* Cardiopulmonary Resuscitation* / methods Disease Models, Animal Epinephrine / administration & dosage Exhalation* Heart Arrest / etiology, metabolism, physiopathology, therapy* Heart Auscultation Heart Massage Heart Rate* Humans Infant, Newborn Positive-Pressure Respiration Predictive Value of Tests Sus scrofa Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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KL2 RR024983-03/RR/NCRR NIH HHS; KL2RR024983/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic Agonists; 0/Biological Markers; 124-38-9/Carbon Dioxide; 51-43-4/Epinephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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