Continuous chest compressions with asynchronous ventilations increase carotid blood flow in the perinatal asphyxiated lamb model

Introduction: The treatment of pseudo electro-mechanical dissociation (P-EMD) with standard chest compressions leads to some compressions that interfere with blood flow created by ventricular contraction and others that are synergistic. We have previously reported that the hemodynamics generated by standard chest compressions (StdCPR) depended on the time interval between the R-wave and the maximum compression pressure (t_int). Our goal was to use the t_int to identify the optimal timing for compression synchronization and to validate the delivery of synchronized chest compressions. Methods: Eight animals underwent surgical preparation and were exposed to hypoxia to induce P-EMD. The treatment period was divided into eight 45 sec epochs during which the P-EMD was left untreated or was treated with StdCPR or chest compressions synchronized to the R-wave in the ECG (SyncCPR). For each heart beat t_int was calculated as t peak AOP - t Rwave , blood pressures were averaged, and blood flows were integrated. 1,598 chest compressions were analyzed. The location of local extrema in hemodynamic parameters as a function of positive t_int values were identified recursively by dividing the range of t_int values into increasing numbers of bins and determining which bin had the highest mean value. Results: Blood flows and pressures exhibited a non-linear dependence on t_int. The maximum CPP occurred at t_int = 90 ±2.3 ms. The maximum aortic pressure occurred at t_int = 70 ±2.3 ms. The minimum right atrial pressure occurred at t_int = 280 ±2.3 ms. The maximum carotid blood flow occurred at t_int = 100 ±2.3 ms. The maximum jugular blood flow occurred at t_int = 400 ±2.3 ms. Unsynchronized chest compressions resulted in a t_int of -21 ± 170 ms. Synchronized chest compressions resulted in a t_int of 119 ± 13 ms. Conclusions: Local maxima and minima during StdCPR were identified in several hemodynamic parameters, but the extrema were not perfectly co-located. It appears that a t_int of 90-100 ms could be optimal. SyncCPR were delivered at 119 ms, which is not far from the local maxima observed for CPP and carotid blood flow.

Download Full-text

Effects of varying chest compression depths on carotid blood flow and blood pressure in asphyxiated piglets

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2020-319473 ◽

2021 ◽

pp. fetalneonatal-2020-319473

Author(s):

Marlies Bruckner ◽

Megan O’Reilly ◽

Tze-Fun Lee ◽

Mattias Neset ◽

Po-Yin Cheung ◽

...

Keyword(s):

Blood Pressure ◽

Blood Flow ◽

Systolic Blood Pressure ◽

Neonatal Resuscitation ◽

Chest Compressions ◽

Carotid Blood Flow ◽

Newborn Piglets ◽

Resuscitation Guidelines ◽

Registration Number ◽

Anterior Posterior

BackgroundCurrent neonatal resuscitation guidelines recommend chest compressions (CCs) should be delivered to a depth of approximately 1/3 of the anterior–posterior (AP) chest diameter. The aim of the study was to investigate the haemodynamic effects of different CC depths in a neonatal piglet model.MethodsCCs were performed with an automated CC machine with 33%, 40% and 25% AP chest diameter in all piglets in the same order for a duration of 3 min each.ResultsEight newborn piglets (age 1–3 days, weight 1.7–2.3 kg) were included in the study. Carotid blood flow (CBF) and systolic blood pressure were the highest using a CC depth of 40% AP chest diameter (19.3±7.5 mL/min/kg and 58±32 mm Hg).ConclusionCC depth influences haemodynamic parameters in asphyxiated newborn piglets during cardiopulmonary resuscitation. The highest CBF and systolic blood pressure were achieved using a CC depth of 40% AP chest diameter.Trial registration numberPCTE0000148.

Download Full-text

COMPARISON OF CAROTID BLOOD FLOW DURING CPR AND CHEST COMPRESSIONS WITH CPAP IN A PORCINE MODEL

Anesthesia & Analgesia ◽

10.1097/00000539-199802001-00127 ◽

1998 ◽

Vol 86 (Supplement) ◽

pp. 128S

Author(s):

ZG Hevesi ◽

&NA; Thrush ◽

JB Downs ◽

RA Smith

Keyword(s):

Blood Flow ◽

Porcine Model ◽

Chest Compressions ◽

Carotid Blood Flow

Download Full-text

Corpuls CPR Generates Higher Mean Arterial Pressure Than LUCAS II in a Pig Model of Cardiac Arrest

BioMed Research International ◽

10.1155/2017/5470406 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

S. Eichhorn ◽

A. Mendoza ◽

A. Prinzing ◽

A. Stroh ◽

L. Xinghai ◽

...

Keyword(s):

Blood Flow ◽

Chest Compression ◽

Near Infrared ◽

Coronary Perfusion Pressure ◽

Spontaneous Circulation ◽

Pig Model ◽

Coronary Perfusion ◽

Organ Perfusion ◽

Chest Compressions ◽

Carotid Blood Flow

According to the European Resuscitation Council guidelines, the use of mechanical chest compression devices is a reasonable alternative in situations where manual chest compression is impractical or compromises provider safety. The aim of this study is to compare the performance of a recently developed chest compression device (Corpuls CPR) with an established system (LUCAS II) in a pig model. Methods. Pigs (n = 5/group) in provoked ventricular fibrillation were left untreated for 5 minutes, after which 15 min of cardiopulmonary resuscitation was performed with chest compressions. After 15 min, defibrillation was performed every 2 min if necessary, and up to 3 doses of adrenaline were given. If there was no return of spontaneous circulation after 25 min, the experiment was terminated. Coronary perfusion pressure, carotid blood flow, end-expiratory CO2, regional oxygen saturation by near infrared spectroscopy, blood gas, and local organ perfusion with fluorescent labelled microspheres were measured at baseline and during resuscitation. Results. Animals treated with Corpuls CPR had significantly higher mean arterial pressures during resuscitation, along with a detectable trend of greater carotid blood flow and organ perfusion. Conclusion. Chest compressions with the Corpuls CPR device generated significantly higher mean arterial pressures than compressions performed with the LUCAS II device.

Download Full-text

Correlation between Carotid Blood Flow and Brain Atrophy in Patients with Multi-Infarct Dementia

Gerontology ◽

10.1159/000213022 ◽

1989 ◽

Vol 35 (4) ◽

pp. 192-197 ◽

Cited By ~ 2

Author(s):

K. Yamashita ◽

S. Kobayashi ◽

S. Yamaguchi ◽

M. Kitani ◽

K. Okada ◽

...

Keyword(s):

Blood Flow ◽

Brain Atrophy ◽

Carotid Blood Flow

Download Full-text

Changes in carotid blood flow and electrocardiogram in humans during and after walking on a treadmill

European Journal of Applied Physiology and Occupational Physiology ◽

10.1007/bf00241643 ◽

1993 ◽

Vol 67 (6) ◽

pp. 486-491 ◽

Cited By ~ 9

Author(s):

Jufang He ◽

Zheng-Lin Jiang ◽

Hiroyuki Tanaka ◽

Toshitaka Ikehara ◽

Akira Takahashi ◽

...

Keyword(s):

Blood Flow ◽

Carotid Blood Flow

Download Full-text

The Action of Ergotamine on the Distribution of Carotid Blood Flow - the Migraine Shunt Theory Revisited

Headache The Journal of Head and Face Pain ◽

10.1111/j.1526-4610.1980.hed2003143.x ◽

1980 ◽

Vol 20 (3) ◽

pp. 143-145 ◽

Cited By ~ 3

Author(s):

Egilius L. H. Spierings ◽

Pramod R. Saxena

Keyword(s):

Blood Flow ◽

Carotid Blood Flow

Download Full-text

Experiences with surgical thrombosis of intracranial berry aneurysms and carotid cavernous fistulas

Journal of Neurosurgery ◽

10.3171/jns.1974.41.6.0657 ◽

1974 ◽

Vol 41 (6) ◽

pp. 657-670 ◽

Cited By ~ 114

Author(s):

Sean Mullan

Keyword(s):

Blood Flow ◽

Intracranial Aneurysm ◽

Carotid Cavernous Fistula ◽

Content Type ◽

Cavernous Fistula ◽

Carotid Blood Flow ◽

Giant Intracranial Aneurysm ◽

Surgical Methods ◽

Carotid Cavernous Fistulas ◽

Fine Print

✓ The results of 61 cases of stereotaxic thrombosis of intracranial berry aneurysms indicate that the technique in selected cases is comparable to, but not necessarily superior to standard surgical methods. The results of wire-induced thrombosis in 15 cases of giant intracranial aneurysm suggest that this method is effective in situations where clipping and encapsulation are inapplicable. The results of thrombosis in six cases of carotid cavernous fistula suggest that intracavernous wire thrombosis may prove to be the treatment of choice in that it seals the fistula without impairing carotid blood flow.

Download Full-text