Georg M Schmölzer1, Megan O'Reilly2, Joseph Labossiere3, Tze-Fun Lee2, Shaun Cowan4, Jessica Nicoll2, David L Bigam3, Po-Yin Cheung5. 1. Department of Pediatrics, University of Alberta, Edmonton, Canada; Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada; Department of Pediatrics, Medical University Graz, Graz, Austria. Electronic address: georg.schmoelzer@me.com. 2. Department of Pediatrics, University of Alberta, Edmonton, Canada; Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada. 3. Department of Surgery, University of Alberta, Edmonton, Canada. 4. Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada; Faculty of Science, University of Alberta, Edmonton, Canada. 5. Department of Pediatrics, University of Alberta, Edmonton, Canada; Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada; Department of Surgery, University of Alberta, Edmonton, Canada.
Abstract
OBJECTIVE: In contrast to the resuscitation guidelines of children and adults, guidelines on neonatal resuscitation recommend synchronized 90 chest compressions with 30 manual inflations (3:1) per minute in newborn infants. The study aimed to determine if chest compression with asynchronous ventilation improves the recovery of bradycardic asphyxiated newborn piglets compared to 3:1 Compression:Ventilation cardiopulmonary resuscitation (CPR). INTERVENTION AND MEASUREMENTS: Term newborn piglets (n=8/group) were anesthetized, intubated, instrumented and exposed to 45-min normocapnic hypoxia followed by asphyxia. Protocolized resuscitation was initiated when heart rate decreased to 25% of baseline. Piglets were randomized to receive resuscitation with either 3:1 compressions to ventilations (3:1C:V CPR group) or chest compressions with asynchronous ventilations (CCaV) or sham. Continuous respiratory parameters (Respironics NM3(®)), cardiac output, mean systemic and pulmonary artery pressures, and regional blood flows were measured. MAIN RESULTS: Piglets in 3:1C:V CPR and CCaV CPR groups had similar time to return of spontaneous circulation, survival rates, hemodynamic and respiratory parameters during CPR. The systemic and regional hemodynamic recovery in the subsequent 4h was similar in both groups and significantly lower compared to sham-operated piglets. CONCLUSION: Newborn piglets resuscitated by CCaV had similar return of spontaneous circulation, survival, and hemodynamic recovery compared to those piglets resuscitated by 3:1 Compression:Ventilation ratio.
OBJECTIVE: In contrast to the resuscitation guidelines of children and adults, guidelines on neonatal resuscitation recommend synchronized 90 chest compressions with 30 manual inflations (3:1) per minute in newborn infants. The study aimed to determine if chest compression with asynchronous ventilation improves the recovery of bradycardic asphyxiated newborn piglets compared to 3:1 Compression:Ventilation cardiopulmonary resuscitation (CPR). INTERVENTION AND MEASUREMENTS: Term newborn piglets (n=8/group) were anesthetized, intubated, instrumented and exposed to 45-min normocapnic hypoxia followed by asphyxia. Protocolized resuscitation was initiated when heart rate decreased to 25% of baseline. Piglets were randomized to receive resuscitation with either 3:1 compressions to ventilations (3:1C:V CPR group) or chest compressions with asynchronous ventilations (CCaV) or sham. Continuous respiratory parameters (Respironics NM3(®)), cardiac output, mean systemic and pulmonary artery pressures, and regional blood flows were measured. MAIN RESULTS: Piglets in 3:1C:V CPR and CCaV CPR groups had similar time to return of spontaneous circulation, survival rates, hemodynamic and respiratory parameters during CPR. The systemic and regional hemodynamic recovery in the subsequent 4h was similar in both groups and significantly lower compared to sham-operated piglets. CONCLUSION: Newborn piglets resuscitated by CCaV had similar return of spontaneous circulation, survival, and hemodynamic recovery compared to those piglets resuscitated by 3:1 Compression:Ventilation ratio.
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: Rafael González; Lázaro Pascual; Alexandra Sava; Sara Tolón; Javier Urbano; Jesus López-Herce Journal: World J Pediatr Date: 2017-10-20 Impact factor: 2.764
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