Standardized Post-Resuscitation Damage Assessment of Two Mechanical Chest Compression Devices: A Prospective Randomized Large Animal Trial

Abstract

<jats:title>Abstract</jats:title> <jats:p>Background Mechanical chest compression devices are accepted alternatives for cardiopulmonary resuscitation (CPR) under specific circumstances. Current devices lack prospective and comparative data on their specific cardiovascular effects and potential for severe thoracic injuries. Objectives To compare CPR effectiveness and thoracic injuries of two mechanical chest compression devices in pigs. Study design: Prospective randomised trial Animals: 18 male German landrace pigs Methods Ventricular fibrillation was induced in anaesthetised and instrumented pigs and the animals were randomised into two intervention groups. Mechanical CPR was initiated by means of LUCAS™ 2 (mCCD1) or Corpuls™ cpr (mCCD2) device. Advanced life support was applied for a maximum of 10 cycles and animals achieving ROSC were monitored for 8 hours. Ventilation/perfusion measurements were performed and blood gas analyses were taken. Thoracic injuries were assessed via a standardised damage score. Results Five animals of the mCCD1 group and one animal of the mCCD2 group achieved ROSC (<jats:italic>p</jats:italic> = 0.048). Only the mCCD1 animals survived until the end of the monitoring period (<jats:italic>p</jats:italic> &lt; 0.01). MCCD1 animals showed less pulmonary shunt (<jats:italic>p</jats:italic> = 0.025) and higher normal V/Q (<jats:italic>p</jats:italic> = 0.017) during CPR. MCCD2 animals showed significantly more severe thoracic injuries (<jats:italic>p</jats:italic> = 0.046). Conclusion The LUCAS 2 device shows superior resuscitation outcomes and less thoracic injuries compared to Corpuls cpr when used for experimental CPR in juvenile pigs. Researchers should be aware that different mCCDs for experimental studies may significantly influence the respective outcome of resuscitation studies and affect comparability of different trials. Controlled human and animal CPR studies and a standardised post-resuscitation injury evaluation could help to confirm potential hazards.</jats:p>

Ultra-low tidal volume ventilation during cardiopulmonary resuscitation shows no mitigating effect on pulmonary end-organ damage compared to standard ventilation: insights from a porcine model

“…This could potentially increase the risk of bleeding and affect histological evaluation. However, since the experimental animals exposed to the massive mechanical stress of cardiopulmonary resuscitation [38] did not exhibit significantly elevated values in the sub-item hemorrhage of lung damage concerning the DAD scoring system or showed any macroscopic hemorrhage during necropsy, the effect appears to be negligible in this study.…”