Document Detail


Impairment of carotid artery blood flow by supraglottic airway use in a swine model of cardiac arrest.
MedLine Citation:
PMID:  22465807     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Supraglottic airway devices (SGDs) are often used as an alternative to endotracheal tube (ETT) during cardiopulmonary resuscitation (CPR). SGDs can be inserted 'blindly' and rapidly, without stopping compressions. These devices utilize pressurized balloons to direct air to the trachea and prevent esophagus insufflation. We hypothesize that the use of a SGD will compress the carotid artery and decrease carotid blood flow (CBF) during CPR in pigs. METHODS: Ventricular fibrillation (VF) was induced in 9 female pigs (32±1Kg) followed by 4minutes without compressions. CPR was then performed continuously for 3 six-minute intervals. During each interval, an ETT was used for the first 3minutes, followed by 3minutes of each SGD (King LTS-D™, LMA Flexible™, Combitube™) in a random order. The primary endpoint was mean CBF (ml/min). Statistical comparisons among the 4 airway devices were performed by Wilcoxon Rank test. Post mortem carotid arteriographies were performed with SGDs in place. RESULTS: CBF (medianml/minute; 25/75 percentile) was significantly lower with each SGD [King (10; 6/41), LMA (10; 4/39), and Combitube (5; -0.4/15)] versus ETT (21; 14/46) (p<0.05 for each SGD compared with ETT). Arteriograms showed that with each SGD there was compression of the internal and external carotid vessels. CONCLUSION: The use of 3 different SGDs during CPR significantly decreased CBF in a porcine model of cardiac arrest. While the current study is limited to pigs, the findings suggest that further research on the effects of SGD use in humans and the effects on carotid artery blood flow is warranted.
Authors:
Nicolas Segal; Demetris Yannopoulos; Brian D Mahoney; Ralph J Frascone; Timothy Matsuura; Colin G Cowles; Scott H McKnite; David G Chase
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-27
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-4-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Ireland Ltd.
Affiliation:
Department of Emergency Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA; Department of Medicine-Cardiovascular Division, University of Minnesota Medical Center, University of Minnesota, Minneapolis, MN, USA.
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