| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 1997;95:1635-1641.)
© 1997 American Heart Association, Inc.
Articles |
Assisted Ventilation Does Not Improve Outcome in a Porcine Model of Single-Rescuer Bystander Cardiopulmonary Resuscitation
From the Department of Pediatrics (R.A.B., M.D.B.), Steele Memorial Children's Research Center; University of Arizona Heart Center (R.A.B., K.B.K., R.W.H., A.B.S., C.W.O., G.A.E.), Departments of Medicine (K.B.K., C.W.O., G.A.E.), Anesthesiology (C.W.O.), and Surgery (Emergency Medicine) (A.B.S.), University of Arizona College of Medicine; and Department of Veterinary Medicine (R.W.H.), College of Agriculture, Tucson, Ariz.
Correspondence to Robert A. Berg, MD, Pediatrics/3302, 1501 N Campbell Ave/PO Box 245073, Tucson, AZ 85724-5073. E-mail rberg{at}aruba.ccit.arizona.edu.
Background Mouth-to-mouth rescue breathing is a barrier to the performance of bystander cardiopulmonary resuscitation (CPR). We evaluated the need for assisted ventilation during simulated single-rescuer bystander CPR in a swine model of prehospital cardiac arrest.
Methods and Results Five minutes after ventricular fibrillation, swine were randomly assigned to 8 minutes of hand-bag-valve ventilation with 17% oxygen and 4% carbon dioxide plus chest compressions (CC+V), chest compressions only (CC), or no CPR (control group). Standard advanced life support was then provided. Animals successfully resuscitated received 1 hour of intensive care support and were observed for 24 hours. All 10 CC animals, 9 of the 10 CC+V animals, and 4 of the 6 control animals attained return of spontaneous circulation. Five of the 10 CC animals, 6 of the 10 CC+V animals, and none of the 6 control animals survived for 24 hours (CC versus controls, P=.058; CC+V versus controls, P<.03). All 24-hour survivors were normal or nearly normal neurologically.
Conclusions In this model of prehospital single-rescuer bystander CPR, successful initial resuscitation, 24-hour survival, and neurological outcome were similar after chest compressions only or chest compressions plus assisted ventilation. Both techniques tended to improve outcome compared with no bystander CPR.
Key Words: cardiopulmonary resuscitation • fibrillation • heart arrest • ventilation • survival
This article has been cited by other articles:
 |
|
 |
|
  M. R. Sayre, R. A. Berg, D. M. Cave, R. L. Page, J. Potts, and R. D. White Hands-Only (Compression-Only) Cardiopulmonary Resuscitation: A Call to Action for Bystander Response to Adults Who Experience Out-of-Hospital Sudden Cardiac Arrest: A Science Advisory for the Public From the American Heart Association Emergency Cardiovascular Care Committee Circulation, April 22, 2008; 117(16): 2162 - 2167. [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Bobrow, L. L. Clark, G. A. Ewy, V. Chikani, A. B. Sanders, R. A. Berg, P. B. Richman, and K. B. Kern Minimally Interrupted Cardiac Resuscitation by Emergency Medical Services for Out-of-Hospital Cardiac Arrest JAMA, March 12, 2008; 299(10): 1158 - 1165. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Iwami, T. Kawamura, A. Hiraide, R. A. Berg, Y. Hayashi, T. Nishiuchi, K. Kajino, N. Yonemoto, H. Yukioka, H. Sugimoto, et al. Effectiveness of Bystander-Initiated Cardiac-Only Resuscitation for Patients With Out-of-Hospital Cardiac Arrest Circulation, December 18, 2007; 116(25): 2900 - 2907. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Steen Does Active Rescuer Ventilation Have a Place During Basic Cardiopulmonary Resuscitation? Circulation, November 27, 2007; 116(22): 2514 - 2516. [Full Text] [PDF]
|
|
|
|
|
|
G. A. Ewy, M. Zuercher, R. W. Hilwig, A. B. Sanders, R. A. Berg, C. W. Otto, M. M. Hayes, and K. B. Kern Improved Neurological Outcome With Continuous Chest Compressions Compared With 30:2 Compressions-to-Ventilations Cardiopulmonary Resuscitation in a Realistic Swine Model of Out-of-Hospital Cardiac Arrest Circulation, November 27, 2007; 116(22): 2525 - 2530. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. Samson, V. M. Nadkarni, P. A. Meaney, S. M. Carey, M. D. Berg, R. A. Berg, and the American Heart Association National Registry o Outcomes of in-hospital ventricular fibrillation in children. N. Engl. J. Med., June 1, 2006; 354(22): 2328 - 2339. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 The International Liaison Committee on Resuscitati The International Liaison Committee on Resuscitation (ILCOR) Consensus on Science With Treatment Recommendations for Pediatric and Neonatal Patients: Pediatric Basic and Advanced Life Support Pediatrics, May 1, 2006; 117(5): e955 - e977. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Part 4: Adult Basic Life Support Circulation, December 13, 2005; 112(24_suppl): IV-19 - IV-34. [Full Text] [PDF]
|
|
|
|
|
|
Part 2: Adult Basic Life Support Circulation, November 29, 2005; 112(22_suppl): III-5 - III-16. [Full Text] [PDF]
|
|
|
|
|
|
Part 6: Pediatric Basic and Advanced Life Support Circulation, November 29, 2005; 112(22_suppl): III-73 - III-90. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Hupfl, A. Duma, T. Uray, C. Maier, N. Fiegl, N. Bogner, and P. Nagele Over-the-Head Cardiopulmonary Resuscitation Improves Efficacy in Basic Life Support Performed by Professional Medical Personnel with a Single Rescuer: A Simulation Study Anesth. Analg., July 1, 2005; 101(1): 200 - 205. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Ewy Cardiocerebral Resuscitation: The New Cardiopulmonary Resuscitation Circulation, April 26, 2005; 111(16): 2134 - 2142. [Full Text] [PDF]
|
|
|
|
|
|
K. B. Kern, R. W. Hilwig, R. A. Berg, A. B. Sanders, and G. A. Ewy Importance of Continuous Chest Compressions During Cardiopulmonary Resuscitation: Improved Outcome During a Simulated Single Lay-Rescuer Scenario Circulation, February 5, 2002; 105(5): 645 - 649. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. D. Rea, M. S. Eisenberg, L. L. Culley, and L. Becker Dispatcher-Assisted Cardiopulmonary Resuscitation and Survival in Cardiac Arrest Circulation, November 20, 2001; 104(21): 2513 - 2516. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Berg, A. B. Sanders, K. B. Kern, R. W. Hilwig, J. W. Heidenreich, M. E. Porter, and G. A. Ewy Adverse Hemodynamic Effects of Interrupting Chest Compressions for Rescue Breathing During Cardiopulmonary Resuscitation for Ventricular Fibrillation Cardiac Arrest Circulation, November 13, 2001; 104(20): 2465 - 2470. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Berg, R. W. Hilwig, K. B. Kern, and G. A. Ewy "Bystander" Chest Compressions and Assisted Ventilation Independently Improve Outcome From Piglet Asphyxial Pulseless "Cardiac Arrest" Circulation, April 11, 2000; 101(14): 1743 - 1748. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. A. Ewy and J. P. Ornato Emergency cardiac care: introduction J. Am. Coll. Cardiol., March 15, 2000; 35(4): 825 - 880. [Full Text] [PDF]
|
|
|
|
|
|
R. A. Berg, K. B. Kern, R. W. Hilwig, and G. A. Ewy Assisted Ventilation During `Bystander' CPR in a Swine Acute Myocardial Infarction Model Does Not Improve Outcome Circulation, December 16, 1997; 96(12): 4364 - 4371. [Abstract] [Full Text]
|
|
|
|
|
|
L. B. Becker, R. A. Berg, P. E. Pepe, A. H. Idris, T. P. Aufderheide, T. A. Barnes, T. A. EdD, S. J. Stratton, and N. C. Chandra A Reappraisal of Mouth-to-Mouth Ventilation During Bystander-Initiated Cardiopulmonary Resuscitation : A Statement for Healthcare Professionals From the Ventilation Working Group of the Basic Life Support and Pediatric Life Support Subcommittees, American Heart Association Circulation, September 16, 1997; 96(6): 2102 - 2112. [Full Text]
|
|