Effect of intra-aortic occlusion balloon in external thoracic compressions during CPR in pigs

Abstract

This study was performed to compare the effectiveness of external thoracic compressions with and without intra-aortic occlusion balloon with capnography and coronary and cerebral perfusion pressure (CPP) in the normothermic and traumatic-less cardiopulmonary arrest provoked by a ventricular fibrillation in pigs. This was an experimental study (cross-over study) in 14 pigs with similar characteristics (23 +/- 2 kg, 10-12 weeks of age). After an 8-minute nonintervention period, the cardiopulmonary resuscitation (CPR) consists of 4 periods of 5 minutes alternating CPR with and without intra-aortic occlusion balloon. Main outcomes measured are end-tidal CO(2) (ETCO(2)); intra-aortic, coronary, and cerebral perfusion pressures; blood gas analysis; and blood lactate concentration. At the end of each period, levels are obtained. Postmortem study was made. Inflation of the occlusion balloon provokes an expansion in the ETCO(2) of about 38%. The coronary perfusion pressure initially goes from 10.21 to 29.0 mm Hg after the occlusion of the aorta, which means an increase of 150%. The CPP goes from 12.54 to 39.71 mm Hg after the balloon was inflated, which means an increase of 200%. In all cases the differences are statistically significant (P <.0001). These increases are less important in the final periods. Intra-aortic balloon occlusion increased ETCO(2), coronary, and cerebral perfusion pressures. An early application of this technique was important.