Morin Chelsea, Lee Tze-Fun, O'Reilly Megan, Cheung Po-Yin, Schmölzer Georg M
Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Resusc Plus. 2024 Apr 9;18:100629. doi: 10.1016/j.resplu.2024.100629. eCollection 2024 Jun.
Recently, the American Heart Association released a statement calling for research examining the appropriate age to transition from the neonatal to pediatric cardiopulmonary resuscitation approach to resuscitation.
To compare neonatal and pediatric resuscitation approach by using either continuous chest compression with asynchronized ventilation (CCaV) or continuous chest compression superimposed with sustained inflation (CC + SI) during infant cardiopulmonary resuscitation. We hypothesized that CC + SI compared to CCaV would reduce time to return of spontaneous circulation (ROSC) in infantile piglets with asphyxia-induced bradycardic cardiac arrest.
Twenty infantile piglets (5-10 days old) were anesthetized and asphyxiated by clamping the endotracheal tube. Piglets were randomized to CC + SI or CCaV for resuscitation (n = 10/group). Heart rate, arterial blood pressure, carotid blood flow, cerebral oxygenation, intrathoracic pressure and respiratory parameters were continuously recorded throughout the experiment.
The median (IQR) time to ROSC with CC + SI compared to CCaV was 179 (104-447) vs 660 (189-660), p = 0.05. The number of piglets achieving ROSC with CC + SI and CCaV were 8/10 and 6/10, p = 0.628. Piglets resuscitated with CC + SI required less epinephrine compared to CCaV (p = 0.039). CC + SI increased the intrathoracic pressure throughout resuscitation (p = 0.025) and increased minute ventilation (p < 0.001), compared to CCaV. There was no difference in hemodynamic parameters between groups.
CC + SI improves resuscitative efforts of infantile piglets by increasing the intrathoracic pressure and minute ventilation, and thus reducing the duration of resuscitation, compared to CCaV.
最近，美国心脏协会发布了一份声明，呼吁开展研究，探讨从新生儿心肺复苏方法过渡到儿科心肺复苏方法的合适年龄。
在婴儿心肺复苏期间，通过使用持续胸外按压与非同步通气（CCaV）或持续胸外按压叠加持续充气（CC + SI）来比较新生儿和儿科复苏方法。我们假设，与CCaV相比，CC + SI可缩短窒息诱导的心动过缓性心脏骤停仔猪的自主循环恢复（ROSC）时间。
20头幼龄仔猪（5 - 10日龄）经麻醉后通过夹闭气管导管造成窒息。将仔猪随机分为CC + SI或CCaV组进行复苏（每组n = 10）。在整个实验过程中持续记录心率、动脉血压、颈动脉血流、脑氧合、胸内压和呼吸参数。
与CCaV相比，CC + SI组达到ROSC的中位（IQR）时间为179（104 - 447）秒，而CCaV组为660（189 - 660）秒，p = 0.05。CC + SI组和CCaV组实现ROSC的仔猪数量分别为8/10和6/10，p = 0.628。与CCaV组相比，采用CC + SI复苏的仔猪所需肾上腺素较少（p = 0.039）。与CCaV相比，CC + SI在整个复苏过程中增加了胸内压（p = 0.025）并增加了分钟通气量（p < 0.001）。两组间血流动力学参数无差异。
与CCaV相比，CC + SI通过增加胸内压和分钟通气量改善了幼龄仔猪的复苏效果，从而缩短了复苏持续时间。
