Document Detail


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.
MedLine Citation:
PMID:  17728041     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Yun-Te Chang; Wanchun Tang; James K Russell; Giuseppe Ristagno; Shijie Sun; Max Harry Weil
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-08-28
Journal Detail:
Title:  Resuscitation     Volume:  76     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-15     Completed Date:  2008-04-15     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  285-90     Citation Subset:  IM    
Affiliation:
Weil Institute of Critical Care Medicine, Rancho Mirage, CA 92270-1761, USA.
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MeSH Terms
Descriptor/Qualifier:
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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