Generation of tidal volume via gentle chest pressure in children over one year old

Tsui, Ban C. H.; Horne, Sara; Tsui, Jenkin; Corry, Gareth N.

doi:10.1016/j.resuscitation.2015.02.021

Cited by 15 publications

(16 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study suggests that chest recoil produces an inflation pressuredependent V T allowing passive ventilation during CCs [28]. A similar observation was reported during chest recoil after the application of a downward force on the chest of infants undergoing surgery requiring general anesthesia [29]. Additionally, the first randomized controlled trial comparing CC+SI and 3:1 C:V in preterm infants <33 weeks' gestation during neonatal resuscitation in the delivery room used a distending pressure of 24 cmH 2 O reported adequate V T delivery [30].…”

Section: Discussionsupporting

confidence: 83%

Effects of sustained inflation pressure during neonatal cardiopulmonary resuscitation of asphyxiated piglets

Shim

Kim

Cheung

et al. 2020

Preprint

View full text Add to dashboard Cite

ObjectiveSustained inflation (SI) during chest compression (CC = CC+SI) significantly reduces time to return of spontaneous circulation (ROSC) compared to 3:1 compression-to-ventilation ratio during neonatal resuscitation. However, the optimal peak inflation pressure (PIP) of SI during CC+SI to improve ROSC and hemodynamic recovery in severely asphyxiated piglets is unknown.AimTo examine if different PIPs of SI during CC+SI will improve ROSC and hemodynamic recovery in severely asphyxiated piglets.Intervention and measurementsTwenty-nine newborn piglets (1-3 days old) were anesthetized, intubated, instrumented and exposed to 30-min normocapnic hypoxia followed by asphyxia. Piglets were randomized into four groups: CC+SI with a PIP of 10 cmH2O (CC+SI_PIP_10, n=8), a PIP of 20 cmH2O (CC+SI_PIP_20, n=8), a PIP of 30 cmH2O (CC+SI_PIP_30, n=8), and a sham-operated control group (n=5). Heart rate, arterial blood pressure, carotid blood flow, cerebral oxygenation, and respiratory parameters were continuously recorded throughout the experiment.Main resultsBaseline parameters were similar between all groups. There was no difference in asphyxiation (duration and degree) between intervention groups. PIP correlated positively with tidal volume and inversely with exhaled CO2 during cardiopulmonary resuscitation. Time to ROSC and rate of ROSC were similar between piglets resuscitated with CC+SI_PIP_10, CC+SI_PIP_20, and CC+SI_PIP_30 cmH2O: median (IQR) 75 (63-193) sec, 94 (78-210) sec, and 85 (70-90) sec; 5/8 (63%), 7/8 (88%), and 3/8 (38%) (p=0.56 and p=0.12, respectively). All piglets that achieved ROSC survived to four hours post-resuscitation. Piglets resuscitated with CC+SI_PIP_30 cmH2O exhibited increased concentrations of pro-inflammatory cytokines interleukin-1β and tumour necrosis factor-α in the frontoparietal cerebral cortex (both p<0.05 vs. sham-operated controls).ConclusionsIn asphyxiated term newborn piglets resuscitated by CC+SI, the use of different PIPs resulted in similar time to ROSC, but PIP at 30 cmH2O showed a larger VT delivery, lower exhaled CO2 and increased tissue inflammatory markers in the brain.

show abstract

Section: Discussionsupporting

confidence: 83%

Effects of sustained inflation pressure during neonatal cardiopulmonary resuscitation of asphyxiated piglets

Shim

Kim

Cheung

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The required distending pressure to achieve passive lung ventilation and adequate tidal volume delivery is ~25cmH2O, which correlated in cadaver piglets (r=0.83, p<0.001), manikins (r=0.98, p<0.001), and when combined (piglets + manikins) (r=0.49, p<0.001) 48 . A similar observation was reported during chest recoil after a downward force was applied to the chest of infants undergoing surgery requiring general anesthesia 49 .…”

Section: Chest Compression and Sustained Inflationsupporting

confidence: 78%

“…Overall, median (IQR) tidal volume generated was 2.4 (0.8-4.0)mL/kg 49 , which suggests that chest recoil generates a distending pressure-dependent tidal volume to allow passive ventilation during CC.…”

Section: Chest Compression and Sustained Inflationmentioning

confidence: 98%

Chest Compressions in the Delivery Room

Garcia-Hidalgo

Schmölzer

2018

Preprint

View full text Add to dashboard Cite

Annually, an estimated 13-26 million newborns need respiratory support and 2-3 million newborns need extensive resuscitation, defined as chest compression and 100% oxygen with or without epinephrine in the delivery room. Despite such care, there is a high incidence of mortality and short-term neurologic morbidity. The poor prognosis associated with receiving chest compression alone or with medications in the delivery room raises questions as to whether improved cardiopulmonary resuscitation methods specifically tailored to the newborn could improve outcomes. This review discusses the current recommendations, mode of action, different compression to ventilation ratio, continuous chest compression with asynchronous ventilations, chest compression and sustained inflation optimal depth, and oxygen concentration during cardiopulmonary resuscitation.

show abstract

“…A clinical study of children who were aged less than 17 years demonstrated a passive ventilation equivalent to 20% of the tidal volume achieved with mechanical ventilation during the application and release of chest pressure, due to supra‐atmospheric and negative intrathoracic pressures, respectively . One piglet study demonstrated that chest compressions resulted in passive dead space ventilation during 3:1 C:V CPR, but the passive tidal volume was satisfactory during continuous chest compressions combined with a sustained inflation .…”

Section: Discussionmentioning

confidence: 99%

Resuscitators who compared four simulated infant cardiopulmonary resuscitation methods favoured the three‐to‐one compression‐to‐ventilation ratio

et al. 2016

View full text Add to dashboard Cite

show abstract

Generation of tidal volume via gentle chest pressure in children over one year old

Cited by 15 publications

References 19 publications

Effects of sustained inflation pressure during neonatal cardiopulmonary resuscitation of asphyxiated piglets

Effects of sustained inflation pressure during neonatal cardiopulmonary resuscitation of asphyxiated piglets

Chest Compressions in the Delivery Room

Resuscitators who compared four simulated infant cardiopulmonary resuscitation methods favoured the three‐to‐one compression‐to‐ventilation ratio

Contact Info

Product

Resources

About