Abstract 18341: Worsened Survival With Head-up Positional Cardiopulmonary Resuscitation in a Porcine Cardiac Arrest Model
Introduction: The body position of cardiopulmonary resuscitation (CPR) could be selected with mechanical chest compression devices. Previous studies have shown that a CPR position where the head tilts up at 30° is hemodynamically more beneficial than a supine position in a porcine cardiac arrest model. This study aimed to verify the effect of head-up positioning on survival after CPR in a porcine cardiac arrest model.
Methods: We performed a randomized experimental trial using female farm pigs (n = 18) (42 ± 3 kg) that were sedated, intubated, and paralyzed on a tilting surgical table. After surgical preparation, 15 minutes of untreated ventricular fibrillation was induced. Thereafter, 6 minutes of basic life support was performed in a position randomly assigned to either head-up tilt at 30° or supine, with a mechanical CPR device, Lucas-2 (L) and an impedance threshold device (ITD). This was followed by 20 minutes of advanced cardiac life support with L-CPR + ITD in the same position. The main outcome of the study was 24-hour survival, analyzed by Fisher’s exact test.
Results: In the head-up position group, 8 pigs were included. One pig experienced recovery of spontaneous circulation (ROSC), but expired after 24 hours. In total, all 8 pigs expired in the head-up group. In the supine position group, 8 pigs were included, 6 pigs experienced ROSC, and survived for 24 hours. Two pigs expired (no ROSC) in the supine group. There was statistical significance of survival between the two groups (p < 0.01 by Fisher’s exact test).
Conclusions: The result implicated that the head-up 30° position of mechanical CPR worsens survival in a porcine cardiac arrest model.
Author Disclosures: Y. Park: None. S. Shin: None. K. Song: None. K. Lee: None. K. Hong: None. Y. Ro: None.
- © 2016 by American Heart Association, Inc.