Abstract 175: Continuous Compression Without Defibrillation Favored No Short-Term Survival in Prolonged Ventricular Fibrillation
Objective: A period of cardiopulmonary resuscitation (CPR) before defibrillation may benefit prolonged ventricular fibrillation (VF), however, optimal duration of CPR has not yet been determined. Based on the hypothesis that continuous chest compression might favor coronary perfusion pressure (CPP), we aimed to compare the effect of increasing CPR from 2 to 4 min prior to defibrillation on short-term survival in a canine VF model.
Methods: After 12-min of untreated VF, 20 anesthetized and intubated dogs were randomized to receive 2 or 4 min CPR prior to the first defibrillation. If this defibrillation failed to produce resuscitation, both groups received comparable resuscitation interventions. Measurements and main
Results: Aortic pressure (AOP) and right atrial pressure (RAP) were measured continuously, and CPP was calculated as AOP-RAP during decompression. 2-min CPR group and 4-min CPR group demonstrated comparable AOP in the first 3 minute but AOP in 2-min group became prominent higher in the 4th minute (97.75+/−46.22mmHg vs. 60.74+/−23.45mmHg during compression,p=0.04). With comparable RAP, CPP in the 2-min group also demonstrated significant higher in the 4th minute than the 4-min group (p=0.01). However, the 2 groups did not differ in ROSC (66.7% and 41.67% for 2-and 4-min CPR, respectively, p=0.41) or survival rate at 2 hr (50% vs. 33.3%, p=0.68).
Conclusions: Prolonged continuous chest compression to 4 minutes favored no ROSC and short-term survival rate in the present 12-minute VF model. As longer compression might compromise resuscitation effectiveness, 2 minutes of CPR prior to initial defibrillation was recommended.
- © 2010 by American Heart Association, Inc.