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One oxygen breath shortened the time to return of spontaneous circulation in severely asphyxiated piglets

Linner, Rikard LU ; Cunha-Goncalves, Doris LU and Perez-de-Sa, Valeria LU (2017) In Acta Paediatrica, International Journal of Paediatrics 106(10). p.1556-1563
Abstract

Aim: Asphyxiated neonates should be resuscitated with air, but it remains unclear if oxygen supplementation is needed in ineffectively ventilated newborn infants. We studied the return of spontaneous circulation (ROSC) with oxygen or air in an experimental model of inadequate ventilation. Methods: Asphyxia was induced in 16 newborn piglets until their heart rate was <60 bpm or mean arterial pressure (MAP) <30 mmHg. During the first 10 minutes of resuscitation, they received one breath per minute of oxygen (n = 8) or air (n = 8). Tidal volume was 7.5 mL/kg. If MAP was <30 mmHg for 15 seconds, closed-chest cardiac massage (CCCM) was performed for 45 seconds. From 10 minutes onward, all piglets received normal ventilation with... (More)

Aim: Asphyxiated neonates should be resuscitated with air, but it remains unclear if oxygen supplementation is needed in ineffectively ventilated newborn infants. We studied the return of spontaneous circulation (ROSC) with oxygen or air in an experimental model of inadequate ventilation. Methods: Asphyxia was induced in 16 newborn piglets until their heart rate was <60 bpm or mean arterial pressure (MAP) <30 mmHg. During the first 10 minutes of resuscitation, they received one breath per minute of oxygen (n = 8) or air (n = 8). Tidal volume was 7.5 mL/kg. If MAP was <30 mmHg for 15 seconds, closed-chest cardiac massage (CCCM) was performed for 45 seconds. From 10 minutes onward, all piglets received normal ventilation with air. ROSC was defined as a heart rate >150 bpm, MAP >40 mmHg and no subsequent CCCM. Results: Before resuscitation, the median arterial pH was 6.73. At 10 minutes, no piglets in the oxygen group needed CCCM, while all did in the air group (p < 0.001). The median time to ROSC was 60 seconds with oxygen and 845 seconds with air (p < 0.001). No brain tissue hyperoxia occurred. Conclusion: When ventilation was inadequate, one oxygen breath reduced time to ROSC in piglets with severe metabolic and respiratory acidosis.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Birth asphyxia, Cerebral oxygenation, Inadequate ventilation, Neonatal resuscitation, Oxygen administration
in
Acta Paediatrica, International Journal of Paediatrics
volume
106
issue
10
pages
1556 - 1563
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • scopus:85020878270
  • wos:000409348400005
ISSN
0803-5253
DOI
10.1111/apa.13920
language
English
LU publication?
yes
id
6e64c6c7-8e34-462a-a862-116465ea4e25
date added to LUP
2017-08-22 11:00:28
date last changed
2018-01-31 14:14:19
@article{6e64c6c7-8e34-462a-a862-116465ea4e25,
  abstract     = {<p>Aim: Asphyxiated neonates should be resuscitated with air, but it remains unclear if oxygen supplementation is needed in ineffectively ventilated newborn infants. We studied the return of spontaneous circulation (ROSC) with oxygen or air in an experimental model of inadequate ventilation. Methods: Asphyxia was induced in 16 newborn piglets until their heart rate was &lt;60 bpm or mean arterial pressure (MAP) &lt;30 mmHg. During the first 10 minutes of resuscitation, they received one breath per minute of oxygen (n = 8) or air (n = 8). Tidal volume was 7.5 mL/kg. If MAP was &lt;30 mmHg for 15 seconds, closed-chest cardiac massage (CCCM) was performed for 45 seconds. From 10 minutes onward, all piglets received normal ventilation with air. ROSC was defined as a heart rate &gt;150 bpm, MAP &gt;40 mmHg and no subsequent CCCM. Results: Before resuscitation, the median arterial pH was 6.73. At 10 minutes, no piglets in the oxygen group needed CCCM, while all did in the air group (p &lt; 0.001). The median time to ROSC was 60 seconds with oxygen and 845 seconds with air (p &lt; 0.001). No brain tissue hyperoxia occurred. Conclusion: When ventilation was inadequate, one oxygen breath reduced time to ROSC in piglets with severe metabolic and respiratory acidosis.</p>},
  author       = {Linner, Rikard and Cunha-Goncalves, Doris and Perez-de-Sa, Valeria},
  issn         = {0803-5253},
  keyword      = {Birth asphyxia,Cerebral oxygenation,Inadequate ventilation,Neonatal resuscitation,Oxygen administration},
  language     = {eng},
  month        = {05},
  number       = {10},
  pages        = {1556--1563},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Acta Paediatrica, International Journal of Paediatrics},
  title        = {One oxygen breath shortened the time to return of spontaneous circulation in severely asphyxiated piglets},
  url          = {http://dx.doi.org/10.1111/apa.13920},
  volume       = {106},
  year         = {2017},
}