Haemodynamic outcomes during piston-based mechanical CPR with or without active decompression in a porcine model of cardiac arrest
(2018) In Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 26(31).- Abstract
Background: Experimental active compression-decompression (ACD) CPR is associated with increased haemodynamic outcomes compared to standard mechanical chest compressions. Since no clinically available mechanical chest compression device is capable of ACD-CPR, we modified the LUCAS 2 (Physio-Control, Lund, Sweden) to deliver ACD-CPR, hypothesising it would improve haemodynamic outcomes compared with standard LUCAS CPR on pigs with cardiac arrest. Methods: The modified LUCAS delivering 5 cm compressions with or without 2 cm active decompression above anatomical chest level was studied in a randomized crossover design on 19 Norwegian domestic pigs. VF was electrically induced and untreated for 2 min. Each pig received ACD-CPR and standard... (More)
Background: Experimental active compression-decompression (ACD) CPR is associated with increased haemodynamic outcomes compared to standard mechanical chest compressions. Since no clinically available mechanical chest compression device is capable of ACD-CPR, we modified the LUCAS 2 (Physio-Control, Lund, Sweden) to deliver ACD-CPR, hypothesising it would improve haemodynamic outcomes compared with standard LUCAS CPR on pigs with cardiac arrest. Methods: The modified LUCAS delivering 5 cm compressions with or without 2 cm active decompression above anatomical chest level was studied in a randomized crossover design on 19 Norwegian domestic pigs. VF was electrically induced and untreated for 2 min. Each pig received ACD-CPR and standard mechanical CPR in three 180-s. phases. We measured aortic, right atrial, coronary perfusion, intracranial and oesophageal pressure, cerebral and carotid blood flow and cardiac output. Two-sided paired samples t-test was used for continuous parametric data and Wilcoxon test for non-parametric data. P<0.05 was considered significant. Results: Due to injuries/device failure, the experimental protocol was completed in nine of 19 pigs. Cardiac output (l/min, median, (25, 75-percentiles): 1.5 (1.1, 1.7) vs. 1.1 (0.8, 1.5), p<0.01), cerebral blood flow (AU, 297 vs. 253, mean difference: 44, 95% CI; 14-74, p=0.01), and carotid blood flow (l/min, median, (25, 75-percentiles): 97 (70, 106) vs. 83 (57, 94), p<0.01) were higher during ACD-CPR compared to standard mechanical CPR. Coronary perfusion pressure (CPP) trended towards higher in end decompression phase. Conclusion: Cardiac output and brain blood flow improved with mechanical ACD-CPR and CPP trended towards higher during end-diastole compared to standard LUCAS CPR.
(Less)
- author
- Steinberg, Mikkel T. ; Olsen, Jan Aage ; Eriksen, Morten ; Neset, Andres ; Norseng, Per Andreas ; Kramer-Johansen, Jo ; Hardig, Bjarne Madsen LU and Wik, Lars
- publishing date
- 2018-04-24
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Active decompression, Cardiac arrest, Experimental porcine model
- in
- Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
- volume
- 26
- issue
- 31
- article number
- 31
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85045732703
- pmid:29690910
- ISSN
- 1757-7241
- DOI
- 10.1186/s13049-018-0496-z
- project
- Helsingborg Resuscitation and Cardiovascular Research Group
- language
- English
- LU publication?
- no
- id
- 4733026c-b9db-40c8-9f10-a060c0efa9c2
- date added to LUP
- 2019-05-22 11:49:25
- date last changed
- 2024-08-20 18:36:48
@article{4733026c-b9db-40c8-9f10-a060c0efa9c2,
abstract = {{<p>Background: Experimental active compression-decompression (ACD) CPR is associated with increased haemodynamic outcomes compared to standard mechanical chest compressions. Since no clinically available mechanical chest compression device is capable of ACD-CPR, we modified the LUCAS 2 (Physio-Control, Lund, Sweden) to deliver ACD-CPR, hypothesising it would improve haemodynamic outcomes compared with standard LUCAS CPR on pigs with cardiac arrest. Methods: The modified LUCAS delivering 5 cm compressions with or without 2 cm active decompression above anatomical chest level was studied in a randomized crossover design on 19 Norwegian domestic pigs. VF was electrically induced and untreated for 2 min. Each pig received ACD-CPR and standard mechanical CPR in three 180-s. phases. We measured aortic, right atrial, coronary perfusion, intracranial and oesophageal pressure, cerebral and carotid blood flow and cardiac output. Two-sided paired samples t-test was used for continuous parametric data and Wilcoxon test for non-parametric data. P<0.05 was considered significant. Results: Due to injuries/device failure, the experimental protocol was completed in nine of 19 pigs. Cardiac output (l/min, median, (25, 75-percentiles): 1.5 (1.1, 1.7) vs. 1.1 (0.8, 1.5), p<0.01), cerebral blood flow (AU, 297 vs. 253, mean difference: 44, 95% CI; 14-74, p=0.01), and carotid blood flow (l/min, median, (25, 75-percentiles): 97 (70, 106) vs. 83 (57, 94), p<0.01) were higher during ACD-CPR compared to standard mechanical CPR. Coronary perfusion pressure (CPP) trended towards higher in end decompression phase. Conclusion: Cardiac output and brain blood flow improved with mechanical ACD-CPR and CPP trended towards higher during end-diastole compared to standard LUCAS CPR.</p>}},
author = {{Steinberg, Mikkel T. and Olsen, Jan Aage and Eriksen, Morten and Neset, Andres and Norseng, Per Andreas and Kramer-Johansen, Jo and Hardig, Bjarne Madsen and Wik, Lars}},
issn = {{1757-7241}},
keywords = {{Active decompression; Cardiac arrest; Experimental porcine model}},
language = {{eng}},
month = {{04}},
number = {{31}},
publisher = {{BioMed Central (BMC)}},
series = {{Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine}},
title = {{Haemodynamic outcomes during piston-based mechanical CPR with or without active decompression in a porcine model of cardiac arrest}},
url = {{http://dx.doi.org/10.1186/s13049-018-0496-z}},
doi = {{10.1186/s13049-018-0496-z}},
volume = {{26}},
year = {{2018}},
}