| Exclusion of a patient assessment interval and extension of the CPR interval both mitigate post-resuscitation myocardial dysfunction in a swine model of cardiac arrest. | |
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MedLine Citation:
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PMID: 17728041 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM OF STUDY: Interruptions in cardiopulmonary resuscitation (CPR), particularly as guided by automated external defibrillators, have been implicated in poor survival from cardiac arrest. Interruptions of CPR may be reduced by eliminating repetition of shocks between periods of CPR, elimination of the interval for patient assessment before CPR, and extension of the periods of CPR. MATERIALS AND METHODS: The effects of exclusion of a 30s post-shock assessment interval prior to CPR and use of a longer interval (180s versus 90s) of CPR on resuscitation and post-resuscitation function were assessed in a factorial design using an established swine model of cardiac arrest. Repetitive shocks were excluded. Ventricular fibrillation was induced ischemically and maintained untreated for 5min. RESULTS: All subjects were resuscitated, 95% survived 3 days, and 97% of survivors had full neurological recovery. Exclusion of the assessment interval reduced the delay to first return of spontaneous circulation by 33.1s (P=0.004) and the delay to sustained resuscitation by 99.2s (P=0.004), reduced post-resuscitation ECG ST elevation by 0.12mV (P=0.03), and alleviated transient post-resuscitation ejection fraction reduction (P<0.0001). Extension of the CPR interval reduced transient post-resuscitation fractional area change impairment (P=0.003). CONCLUSIONS: Exclusion of an interval for assessment of airway, breathing and signs of circulation mitigates post-resuscitation dysfunction in a swine model of cardiac arrest. Extension of the period of CPR independently provides measurable, though less comprehensive, mitigation as well. |
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Authors:
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Yun-Te Chang; Wanchun Tang; James K Russell; Giuseppe Ristagno; Shijie Sun; Max Harry Weil |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-08-28 |
Journal Detail:
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Title: Resuscitation Volume: 76 ISSN: 0300-9572 ISO Abbreviation: Resuscitation Publication Date: 2008 Feb |
Date Detail:
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Created Date: 2008-01-15 Completed Date: 2008-04-15 Revised Date: 2009-08-25 |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 285-90 Citation Subset: IM |
Affiliation:
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Weil Institute of Critical Care Medicine, Rancho Mirage, CA 92270-1761, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cardiopulmonary Resuscitation / adverse effects, methods* Defibrillators Disease Models, Animal Electric Countershock / adverse effects, instrumentation* Electrocardiography Emergency Medical Services Heart Arrest / mortality, physiopathology, therapy* Male Survival Rate Swine Treatment Outcome Ventricular Dysfunction / etiology*, mortality, physiopathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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