Comparison of hemodynamic effects of chest compression delivered via machine or human in asphyxiated piglets

Abstract

Background High-quality chest compressions (CC) are an important factor of neonatal resuscitation. Mechanical CC devices may provide superior CC delivery and improve resuscitation outcomes. We aimed to compare the hemodynamic effects of CC delivered by machine and human using a neonatal piglet model. Methods Twelve asphyxiated piglets were randomized to receive CC during resuscitation using an automated mechanical CC device (“machine”) or the two-thumb encircling technique (“human”). CC was superimposed with sustained inflations. Results Twelve newborn piglets (age 0–3 days, weight 2.12 ± 0.17 kg) were included in the study. Machine-delivered CC resulted in an increase in stroke volume, and minimum and maximum rate of left ventricle pressure change (dp/dtmin and dp/dtmax) compared to human-delivered CC. Conclusions During machine-delivered CC, stroke volume and left ventricular contractility were significantly improved. Mechanical CC devices may provide improved cardiopulmonary resuscitation outcomes in neonatal cardiac arrest induced by asphyxia. Impact Machine chest compression leads to changes in hemodynamic parameters during resuscitation of asphyxiated neonatal piglets, namely greater stroke volume and left ventricular contractility, compared with standard two-thumb compression technique. Mechanical chest compression devices may provide improved cardiopulmonary resuscitation outcomes in neonatal and pediatric asphyxia-induced cardiac arrest.

Femoral Occlusion during Neonatal Cardiopulmonary Resuscitation Improves Outcomes in an Ovine Model of Perinatal Cardiac Arrest

“…Endotracheal or intramuscular epinephrine is not associated with any significant hemodynamic improvement during chest compressions, possibly due to poor bioavailability [32,33]. O'Reilly et al have shown increased stroke volume, but no improvement in diastolic pressure during chest compressions using a mechanical device [34]. Administering a normal saline bolus can potentially increase the diastolic pressure, but requires umbilical venous catheterization and intraosseous line placement and may be associated with pulmonary edema [35].…”