Abstract P19: Feasibility Of Transnasal Cooling Without Airway Protection During Cardiopulmonary Resuscitation
Objectives. The present study investigated the feasibility of transnasal cooling during CPR with chest compressions (CC) only, without airway protection or ventilation in a porcine model of cardiac arrest. We hypothesized that transnasal cooling during CPR without airway protection or ventilation would not affect resuscitation and survival.
Materials and methods. Ventricular fibrillation (VF) was electrically induced and untreated for 7 min in domestic male pigs. Continuous CC were then delivered for 5 min prior to defibrillation. At the onset of CC, animals were subjected to transnasal cooling with the BeneChill device, which sprays oxygen and liquid coolant PFC into the nasal cavity. No airway protection or ventilation were established. Immediately after return of spontaneous circulation (ROSC), animals were intubated and ventilated. Arterial PO2 was continuously monitored. Animals survived 96 hrs.
Results. All animals were successfully resuscitated with a CPR duration of 317 ± 24 sec and following a single defibrillation attempt. Arterial PO2 was 105 ± 3 mmHg at baseline, 85 ± 14 mmHg after 7 min of untreated VF and 233 ± 169 mmHg after the 5 min of unventilated CC with cooling (PR in Table⇓). FiO2 was 100% post-ROSC and was progressively tapered to 21% over 3.5 ± 2 hrs. PFC was aspirated during chest compression and confirmed radiologically. Subsequent respiratory care included positive pressure ventilation with low tidal volume and prone position for 8 ± 4 hrs. There were no adverse respiratory effects. Animals were successfully extubated. At 24 and 96 hrs, all animals were breathing normally.
Conclusions. In this model, transnasal cooling during CPR with chest compressions only and without airway protection or ventilation is feasible for oxygenation, resuscitation and survival.