However, regulate ventilations during CCC with miniaturized mechanical chest compressor might increase the incidence of rib fractures or lung injury because of the asynchronism between compression and ventilation. Previously, our group has demonstrated that CCC with miniaturized mechanical chest compressor combined with regular mechanical ventilations improved hemodynamic efficacy and the success of CPR, resulting in better post-resuscitation myocardial and neurological recovery ( 12). However, little research has been developed to focus on this controversy during mechanical CPR. Furthermore, the latest guidelines also emphasize CCC combined with regular ventilations in CA patients when an advanced airway exists.Ĭurrently, the ideal C:V ratio and the necessity of ventilation during CPR is still under question.
#Ideal chest compression fraction manual#
Animal experiments and clinical studies have proven that resuscitation outcomes were similar or better in compression-only CPR when compared with conventional manual CPR ( 6- 11). However, continuous chest compression (CCC) with or without ventilations was recently recommended by the AHA guidelines because of the improvement in resuscitation outcomes by minimizing interruption and encouraging more bystander CPR. Animal experiments and computer modeling have demonstrated that vital organ perfusion and resuscitation outcomes are superior with 30:2 ratio ( 2- 5). Since 2005, a C:V ratio of 30:2 is recommended by the American Heart Association (AHA) for adult CPR without advanced airway, with the purpose of improving hemodynamics by decreasing “hands-off” time. Accepted for publication Aug 28, 2017.Īppropriate compression-ventilation (C:V) ratio is an important component of cardiopulmonary resuscitation (CPR), which plays a major role in the chain of survival for cardiac arrest (CA) victims ( 1). Keywords: Cardiopulmonary resuscitation (CPR) cardiac arrest (CA) hemodynamics ventilation However, the incidence of rib fracture increases during the mechanical CPR strategy of CCC combined with regular ventilations.
However, obviously more numbers of rib fracture were observed in CCC animals in comparison with VC animalsĬonclusions: There was no difference in hemodynamic efficacy and gas exchange during and after resuscitation, therefore identical 72 h survival with intact neurologic function was observed in both VC and CCC groups. All animals were successfully resuscitated and survived for 72 h with favorable neurologic outcomes in both groups. Although extravascular lung water index of both groups significantly increased after resuscitation, no distinct difference was found between CCC and VC groups. No significant differences were observed in arterial blood gas parameters between two groups at baseline, VF 6 min, CPR 4 min and 30, 120 and 360 min post-resuscitation. Results: Coronary perfusion pressure, end-tidal carbon dioxide and carotid blood flow in the VC group were similar to those achieved in the CCC group during CPR. The resuscitated animals were observed for 72 h. The protocol was stopped if successful resuscitation or at a total of 15 min. If failed to resuscitation, CPR was resumed for 2 min before the next shock. Defibrillation was delivered by a single 150 J shock after 5 min of CPR. At the same time of beginning of precordial compression, the animals were mechanically ventilated at a rate of 10 breaths-per-minute in the CCC group or with a 30:2 C:V ratio in the VC group. Mechanical chest compression was implemented with a miniaturized mechanical chest compressor. The animals were then randomly assigned to receive CCC combined with regular ventilation (CCC group) or 30:2 CPR (VC group). Ventricular fibrillation was induced and untreated for 7 min. Methods: Sixteen male domestic pigs weighing 39☒ kg were utilized. In this study, we investigated the effects of 30:2 mechanical CPR when compared with CCC in combination with regular ventilation in a porcine model. However, continuous chest compression (CCC) is an alternative strategy for CPR that minimizes interruption especially when an advanced airway exists.
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