Abstract | OBJECTIVES: DESIGN: Randomized interventional study. SETTING: Preclinical animal laboratory. SUBJECTS: Twenty-four 3-month-old female swine. INTERVENTIONS: After 7 minutes of ventricular fibrillation, pigs were randomized to receive one of three resuscitation strategies: 1) Hemodynamic directed care (coronary perfusion pressure-20): chest compressions with depth titrated to a target systolic blood pressure of 100 mm Hg and titration of vasopressors to maintain coronary perfusion pressure greater than 20 mm Hg; 2) Depth 33 mm: target chest compression depth of 33 mm with standard American Heart Association epinephrine dosing; or 3) Depth 51 mm: target chest compression depth of 51 mm with standard American Heart Association epinephrine dosing. All animals received manual cardiopulmonary resuscitation guided by audiovisual feedback for 10 minutes before first shock. MEASUREMENTS AND MAIN RESULTS: Forty-five-minute survival was higher in the coronary perfusion pressure-20 group (8 of 8) compared to depth 33 mm (1 of 8) or depth 51 mm (3 of 8) groups; p equals to 0.002. Coronary perfusion pressures were higher in the coronary perfusion pressure-20 group compared to depth 33 mm (p = 0.004) and depth 51 mm (p = 0.006) and in survivors compared to nonsurvivors (p < 0.01). Total epinephrine dosing and defibrillation attempts were not different. CONCLUSIONS:
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Authors | Stuart H Friess, Robert M Sutton, Utpal Bhalala, Matthew R Maltese, Maryam Y Naim, George Bratinov, Theodore R Weiland 3rd, Mia Garuccio, Vinay M Nadkarni, Lance B Becker, Robert A Berg |
Journal | Critical care medicine
(Crit Care Med)
Vol. 41
Issue 12
Pg. 2698-704
(Dec 2013)
ISSN: 1530-0293 [Electronic] United States |
PMID | 23887237
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Vasoconstrictor Agents
- Epinephrine
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Topics |
- Animals
- Aorta
(physiology)
- Arterial Pressure
(physiology)
- Atrial Pressure
(physiology)
- Blood Gas Analysis
- Cardiopulmonary Resuscitation
(methods)
- Coronary Vessels
(physiology)
- Epinephrine
(administration & dosage)
- Female
- Heart
(physiology)
- Heart Arrest
(blood, physiopathology, therapy)
- Heart Massage
- Random Allocation
- Survival Rate
- Swine
- Vasoconstrictor Agents
(administration & dosage)
- Ventricular Fibrillation
(complications)
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