R A Berg1, K B Kern, R W Hilwig, G A Ewy. 1. University of Arizona Heart Center, and Department of Pediatrics, University of Arizona College of Medicine, Tucson, USA. rberg@peds.arizona.edu
Abstract
BACKGROUND: Mouth-to-mouth rescue breathing is a barrier to the performance of bystander cardiopulmonary resuscitation (CPR). We evaluated the need for assisted ventilation during simulated single-rescuer bystander CPR in a swine myocardial infarction model of prehospital cardiac arrest. METHODS AND RESULTS: Steel cylinders were placed in the mid left anterior descending coronary arteries of 43 swine. Two minutes after ventricular fibrillation, animals were randomly assigned to 10 minutes of hand-bag-valve ventilation with 17% oxygen and 4% carbon dioxide plus chest compressions (CC+V), chest compressions only (CC), or no CPR (control group). Standard advanced life support was then provided. Animals successfully resuscitated received 1 hour of intensive care support and were observed for 24 hours. Five of 14 CC animals, 3 of 15 CC+V animals, and 1 of 14 controls survived for 24 hours (CC versus controls, P=.07). Myocardial oxygen delivery and consumption were greater among surviving animals than nonsurvivors but did not differ between CC and CC+V animals. CONCLUSIONS: In this acute myocardial infarction model of prehospital single-rescuer bystander CPR, assisted ventilation did not improve outcome.
BACKGROUND: Mouth-to-mouth rescue breathing is a barrier to the performance of bystander cardiopulmonary resuscitation (CPR). We evaluated the need for assisted ventilation during simulated single-rescuer bystander CPR in a swinemyocardial infarction model of prehospital cardiac arrest. METHODS AND RESULTS: Steel cylinders were placed in the mid left anterior descending coronary arteries of 43 swine. Two minutes after ventricular fibrillation, animals were randomly assigned to 10 minutes of hand-bag-valve ventilation with 17% oxygen and 4% carbon dioxide plus chest compressions (CC+V), chest compressions only (CC), or no CPR (control group). Standard advanced life support was then provided. Animals successfully resuscitated received 1 hour of intensive care support and were observed for 24 hours. Five of 14 CC animals, 3 of 15 CC+V animals, and 1 of 14 controls survived for 24 hours (CC versus controls, P=.07). Myocardial oxygen delivery and consumption were greater among surviving animals than nonsurvivors but did not differ between CC and CC+V animals. CONCLUSIONS: In this acute myocardial infarction model of prehospital single-rescuer bystander CPR, assisted ventilation did not improve outcome.
Authors: Monica E Kleinman; Allan R de Caen; Leon Chameides; Dianne L Atkins; Robert A Berg; Marc D Berg; Farhan Bhanji; Dominique Biarent; Robert Bingham; Ashraf H Coovadia; Mary Fran Hazinski; Robert W Hickey; Vinay M Nadkarni; Amelia G Reis; Antonio Rodriguez-Nunez; James Tibballs; Arno L Zaritsky; David Zideman Journal: Circulation Date: 2010-10-19 Impact factor: 29.690
Authors: Monica E Kleinman; Allan R de Caen; Leon Chameides; Dianne L Atkins; Robert A Berg; Marc D Berg; Farhan Bhanji; Dominique Biarent; Robert Bingham; Ashraf H Coovadia; Mary Fran Hazinski; Robert W Hickey; Vinay M Nadkarni; Amelia G Reis; Antonio Rodriguez-Nunez; James Tibballs; Arno L Zaritsky; David Zideman Journal: Pediatrics Date: 2010-10-18 Impact factor: 7.124
Authors: U Kreimeier; B Dirks; R Arntz; J Bahr; P Goldschmidt; M Roessler; M Sasse; M Toursarkissian Journal: Anaesthesist Date: 2008-08 Impact factor: 1.041
Authors: Mathias Zuercher; Ronald W Hilwig; James Ranger-Moore; Jon Nysaether; Vinay M Nadkarni; Marc D Berg; Karl B Kern; Robert Sutton; Robert A Berg Journal: Crit Care Med Date: 2010-04 Impact factor: 7.598
Authors: Robert A Berg; Ronald W Hilwig; Marc D Berg; David D Berg; Ricardo A Samson; Julia H Indik; Karl B Kern Journal: Resuscitation Date: 2008-05-14 Impact factor: 5.262
Authors: Julia H Indik; Ronald W Hilwig; Mathias Zuercher; Karl B Kern; Marc D Berg; Robert A Berg Journal: Circ Arrhythm Electrophysiol Date: 2009-02-18
Authors: Julia H Indik; Madhan Shanmugasundaram; Daniel Allen; Amanda Valles; Karl B Kern; Ronald W Hilwig; Mathias Zuercher; Robert A Berg Journal: Resuscitation Date: 2009-10-04 Impact factor: 5.262
Authors: Julia H Indik; Richard L Donnerstein; Ronald W Hilwig; Mathias Zuercher; Justin Feigelman; Karl B Kern; Marc D Berg; Robert A Berg Journal: Crit Care Med Date: 2008-07 Impact factor: 7.598