Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 May 10:24:67.
doi: 10.1186/s13049-016-0262-z.

Four ways to ventilate during cardiopulmonary resuscitation in a porcine model: a randomized study

Benedict Kjærgaard  1   2 , Egidijus Bavarskis  3 , Sigridur Olga Magnusdottir  4 , Charlotte Runge  5   6 , Daiva Erentaite  7 , Jes Sefland Vogt  8 , Mette Dahl Bendtsen  9
Affiliations

Four ways to ventilate during cardiopulmonary resuscitation in a porcine model: a randomized study

Benedict Kjærgaard et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: The optimal method for out-of-hospital ventilation during cardiopulmonary rescue (CPR) is controversial. The aim of this study was to test different modes of ventilation during CPR for a prolonged period of 60 min.

Methods: Pigs were randomized to four groups after the induction of ventricular fibrillation, which was followed by one hour of mechanical cardiac compressions. The study comprised five pigs treated with free airways, five pigs treated with ventilators, six pigs treated with a constant oxygen flow into the tube, and six pigs treated with apnoeic oxygenation.

Results: The free airway group was tested for 1 h, but in the first 15 min, the median PaO2 had already dropped to 5.1 kPa. The ventilator group was tested for 1 h and still had an acceptable median PaO2 of 10.3 kPa in the last 15 min. The group was slightly hyperventilated, with PaCO2 at 3.8 kPa, even though the ventilator volumes were unchanged from those before induction of cardiac arrest. In the group with constant oxygen flowing into the tube, one pig was excluded after 47 min due to blood pressure below 25 mmHg. For the remaining 5 pigs, the median PaO2 in the last 15 min was still 14.3 kPa, and the median PaCO2 was 6.2 kPa. The group with apnoeic oxygenation for 1 h had a resulting median PaO2 of 10.2 kPa and a median PaCO2 of 12.3 kPa in the last 15 min.

Discussion: Except for the free airway group, the other methods resulted in PaO2 above 10 kPa and PaCO2 between 3.8 and 12.3 kPa after one hour.

Conclusion: Constant oxgen flow and apnoeic oxygenation seemed to be useable alternatives to ventilator treatment.

Keywords: CPR; Cardiac arrest; Ventilation methods.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
A specially constructed pig holder for the LUCAS device, which kept the pig securely positioned and slightly turned on the right side
Fig. 2
Fig. 2
During apnoeic oxygenation, pure oxygen is delivered under controlled low pressure
Fig. 3
Fig. 3
Arterial oxygen and carbon dioxide tension during 60 minutes of cardiac compressions for all animals and median arterial tensions for each 15 minutes of cardiac compressions
Fig. 4
Fig. 4
Arterial pH and plasma lactate during 60 minutes of cardiac compressions for all animals
Fig. 5
Fig. 5
Systolic blood pressure during 60 minutes of cardiac compressions
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Wik L, Olsen JA, Persse D, Sterz F, Lozano M, Jr, Brouwer MA, et al. Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial. Resuscitation. 2014;85(6):741–8. doi: 10.1016/j.resuscitation.2014.03.005. - DOI - PubMed
    1. Monsieurs KG, Nolan JP, Bossaert LL, Greif R, Maconochie IK, Nikolaou NI, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary. Resuscitation. 2015;95:1–80. doi: 10.1016/j.resuscitation.2015.07.038. - DOI - PubMed
    1. Nolan JP, Soar J, Cariou A, Cronberg T, Moulaert VR, Deakin CD, et al. European Resuscitation Council and European Society of Intensive Care Medicine Guidelines for Post-resuscitation Care 2015: Section 5 of the European Resuscitation Council Guidelines for Resuscitation 2015. Resuscitation. 2015;95:202–22. doi: 10.1016/j.resuscitation.2015.07.018. - DOI - PubMed
    1. Aufderheide TP, Lurie KG. Death by hyperventilation: a common and life-threatening problem during cardiopulmonary resuscitation. Crit Care Med. 2004;32(9 Suppl):S345–51. doi: 10.1097/01.CCM.0000134335.46859.09. - DOI - PubMed
    1. Maertens VL, De Smedt LE, Lemoyne S, Huybrechts SA, Wouters K, Kalmar AF, et al. Patients with cardiac arrest are ventilated two times faster than guidelines recommend: an observational prehospital study using tracheal pressure measurement. Resuscitation. 2013;84(7):921–6. doi: 10.1016/j.resuscitation.2012.11.015. - DOI - PubMed