![]() Both studies were included in the analysis to increase the generalizability and clinical application of our results. From the second study, only the animals in the control group (Group C ">53 ]) were included because the treatment (n = 27) group received non-standard resuscitation medications that differed substantially from the other 3 groups. From the first study, data from both the experimental (Group A "> ]">26 ]) and control (Group B "> ]">26 ]) groups were used because the groups were similarly treated. A total of 105 female Yorkshire swine (weighing 30 - 35 kg) were included. Both studies were conducted in our USDA-certified laboratory. Animal handling and all surgical procedures were in strict compliance with the NIH Guide for the Care and Use of Animals. This was a secondary analysis of prospectively collected data from two similar IACUC approved protocols. Our hypothesis was that a pause in chest compressions would lead to a precipitous drop in CPP values, but that delivering 30 chest compressions prior to defibrillation would restore a substantial proportion of the decay in CPP. The aim of this study was to quantify the extent to which the decline in CPP values during an interruption in chest compressions for electrocardiogram (ECG) rhythm analysis can be restored with a short period of CPR prior to defibrillation. When chest compression interruptions occur during cardiopulmonary resuscitation (CPR), there is a precipitous and sustained loss of CPP. The importance of myocardial reperfusion, denoted by the achievement of a threshold coronary perfusion pressure (CPP), to defibrillation success beyond the electrical phase of ventricular fibrillation (VF) has been well established. Keywords:Cardiopulmonary Resuscitation, Coronary Perfusion Pressure, Chest Compression Interruptions Conclusion: This study demonstrates that 83% of the decline in CPP values during a planned 10-second interruption in CPR can be restored with a short period of precordial compressions prior to defibrillation. Resuming CPR for restored 83% (95%CI: 78%, 86%) of the CPP lost. Results: Interrupting compressions resulted in a significant drop in CPP (29.8 mmHg to 6.8 mmHg ). Our primary outcome was defined as the ratio of CPP recovery (CPP3- CPP2) to the drop in CPP (CPP1-CPP2). CPP data were extracted from three time points: 2 minutes after epinephrine delivery (CPP1) following the chest compression pause (CPP2) and immediately before defibrillation (CPP3). Following this pause, CPR was resumed for 20- seconds prior to defibrillation. After 10 minutes of untreated VF in the first study (n = 52) and 12 minutes of untreated VF in the second (n = 53), CPR began and epinephrine was administered approximately 2 minutes prior to a planned 10-second pause to record an artifact-free ECG waveform segment. A total of 105 Yorkshire swine were included and VF was electrically induced. Methods: This was a secondary analysis of data from two similar IACUC approved protocols. Objective: To quantify the extent to which CPP recovers to pre-pause levels following chest compression interruptions. Chest compression interruptions cause a precipitous drop in CPP. Received 6 March 2014 revised 16 April 2014 accepted īackground: Sufficient coronary perfusion pressure (CPP) to provide myocardial reperfusion is required for defibrillation success after prolonged ventricular fibrillation (VF) cardiac arrest. This work is licensed under the Creative Commons Attribution International License (CC BY). Department of Emergency Medicine at Baystate Medical Center, Tufts University School of Medicine,Įmail: © 2014 by authors and Scientific Research Publishing Inc.
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