Georg M Schmölzer1, Megan O'Reilly, Joseph Labossiere, Tze-Fun Lee, Shaun Cowan, Sharon Qin, David L Bigam, Po-Yin Cheung. 1. Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada (G.M.S., MO., T.-F.L., P.-Y.C.); Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada (G.M.S., M.O., S.C., S.Q., P.-Y.C.); Department of Pediatrics, Medical University Graz, Graz, Austria (G.M.S.); Department of Surgery, University of Alberta, Edmonton, Alberta, Canada (J.L., D.L.B., P.-Y.C.); and Faculty of Science, University of Alberta, Edmonton, Alberta, Canada (S.C.).
Abstract
BACKGROUND: Guidelines on neonatal resuscitation recommend 90 chest compressions (CCs) and 30 manual inflations (3:1) per minute in newborns. The study aimed to determine whether CC s during sustained inflations (SIs) improves the recovery of asphyxiated newborn piglets in comparison with coordinated 3:1 resuscitation. METHODS AND RESULTS: Term newborn piglets (n=8/group) were anesthetized, intubated, instrumented, and exposed to 45-minute normocapnic hypoxia followed by asphyxia. Piglets were randomly assigned to receive either 3:1 resuscitation (3:1 group) or CCs during SIs (SI group) when the heart rate decreased to 25% of baseline. Piglets randomly assigned to the SI group received SIs with a pressure of 30 cm H2O for 30 s. During the SI, CCs at a rate of 120/min were provided. SI was interrupted after 30 s for 1 s before a further 30-s SI was provided. CCs were continued throughout SIs. CCs and SI were continued until the return of spontaneous circulation. Continuous respiratory parameters, cardiac output, mean systemic and pulmonary artery pressures, and regional blood flows were measured. Mean (standard deviation) time for return of spontaneous circulation was significantly reduced in SI group versus 3:1 group (32 [11] s versus 205 [113] s, respectively). In the SI group, administration of oxygen and epinephrine was significantly lower, whereas minute ventilation and exhaled CO2 were significantly increased. The SI group had significantly higher mean systemic and pulmonary arterial pressures during resuscitation in comparison with the 3:1 group (51 [10] versus 31 [5] mm Hg; 41[7] versus 31 [7] mm Hg, respectively; all P<0.05), with improved cardiac output and carotid blood flow. CONCLUSIONS: Combining CCs and SIs significantly improved the return of spontaneous circulation with better hemodynamic recovery in asphyxiated newborn piglets in comparison with standard coordinated 3:1 resuscitation.
BACKGROUND: Guidelines on neonatal resuscitation recommend 90 chest compressions (CCs) and 30 manual inflations (3:1) per minute in newborns. The study aimed to determine whether CC s during sustained inflations (SIs) improves the recovery of asphyxiated newborn piglets in comparison with coordinated 3:1 resuscitation. METHODS AND RESULTS: Term newborn piglets (n=8/group) were anesthetized, intubated, instrumented, and exposed to 45-minute normocapnic hypoxia followed by asphyxia. Piglets were randomly assigned to receive either 3:1 resuscitation (3:1 group) or CCs during SIs (SI group) when the heart rate decreased to 25% of baseline. Piglets randomly assigned to the SI group received SIs with a pressure of 30 cm H2O for 30 s. During the SI, CCs at a rate of 120/min were provided. SI was interrupted after 30 s for 1 s before a further 30-s SI was provided. CCs were continued throughout SIs. CCs and SI were continued until the return of spontaneous circulation. Continuous respiratory parameters, cardiac output, mean systemic and pulmonary artery pressures, and regional blood flows were measured. Mean (standard deviation) time for return of spontaneous circulation was significantly reduced in SI group versus 3:1 group (32 [11] s versus 205 [113] s, respectively). In the SI group, administration of oxygen and epinephrine was significantly lower, whereas minute ventilation and exhaled CO2 were significantly increased. The SI group had significantly higher mean systemic and pulmonary arterial pressures during resuscitation in comparison with the 3:1 group (51 [10] versus 31 [5] mm Hg; 41[7] versus 31 [7] mm Hg, respectively; all P<0.05), with improved cardiac output and carotid blood flow. CONCLUSIONS: Combining CCs and SIs significantly improved the return of spontaneous circulation with better hemodynamic recovery in asphyxiated newborn piglets in comparison with standard coordinated 3:1 resuscitation.
Authors: Hannah B Andersen; Mads Andersen; Ted C K Andelius; Mette V Pedersen; Bo Løfgren; Michael Pedersen; Steffen Ringgaard; Kasper J Kyng; Tine B Henriksen Journal: Pediatr Res Date: 2022-06-09 Impact factor: 3.756
Authors: Julia Buchmayer; Lukas Wisgrill; Michael Schneider; Tobias Werther; Katharina Goeral; Angelika Berger; Georg M Schmölzer; Michael Wagner Journal: Resusc Plus Date: 2022-06-28
Authors: Elliott Shang-shun Li; Po-Yin Cheung; Megan O'Reilly; Joseph LaBossiere; Tze-Fun Lee; Shaun Cowan; David L Bigam; Georg Marcus Schmölzer Journal: PLoS One Date: 2016-01-14 Impact factor: 3.240