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Combination of cardiac and thoracic pump theories in rodent cardiopulmonary resuscitation: a new method of three-side chest compression
Intensive Care Medicine Experimental Pub Date : 2019-12-01 , DOI: 10.1186/s40635-019-0275-9
Yu Okuma 1 , Koichiro Shinozaki 1, 2 , Tsukasa Yagi 1 , Kota Saeki 3 , Tai Yin 1 , Junhwan Kim 1 , Lance B Becker 1, 2
Affiliation  

BackgroundHigh-quality cardiopulmonary resuscitation (HQ-CPR) is of paramount importance to improve neurological outcomes of cardiac arrest (CA). The purpose of this study was to evaluate chest compression methods by combining two theories: cardiac and thoracic pumps.MethodsMale Sprague-Dawley rats were used. Three types of chest compression methods were studied. The 1-side method was performed vertically with 2 fingers over the sternum. The 2-side method was performed horizontally with 2 fingers, bilaterally squeezing the chest wall. The 3-side method combined the 1-side and the 2-side methods. Rats underwent 10 min of asphyxial CA. We examined ROSC rates, the left ventricular functions, several arterial pressures, intrathoracic pressure, and brain tissue oxygen.ResultsThe 3-side group achieved 100% return of spontaneous circulation (ROSC) from asphyxial CA, while the 1-side group and 2-side group achieved 80% and 60% ROSC, respectively. Three-side chest compression significantly shortened the time for ROSC among the groups (1-side, 105 ± 36.0; 2-side, 141 ± 21.7; 3-side, 57.8 ± 12.3 s, respectively, P < 0.05). Three-side significantly increased the intrathoracic pressure (esophagus, 7.6 ± 1.9, 7.3 ± 2.8, vs. 12.7 ± 2.2; mmHg, P < 0.01), the cardiac stroke volume (the ratio of the baseline 1.2 ± 0.6, 1.3 ± 0.1, vs. 2.1 ± 0.6, P < 0.05), and the common carotid arterial pressure (subtracted by femoral arterial pressure 4.0 ± 2.5, 0.3 ± 1.6, vs. 8.4 ± 2.6; mmHg, P < 0.01). Three-side significantly increased the brain tissue oxygen (the ratio of baseline 1.4±0.1, 1.3±0.2, vs. 1.6 ± 0.04, P < 0.05).ConclusionsThese results suggest that increased intrathoracic pressure by 3-side CPR improves the cardiac output, which may in turn help brain oxygenation during CPR.

中文翻译:

心胸泵理论相结合的啮齿动物心肺复苏:三侧胸外按压新方法

背景高质量的心肺复苏 (HQ-CPR) 对改善心脏骤停 (CA) 的神经学结果至关重要。本研究的目的是通过结合两种理论来评估胸部按压方法:心脏泵和胸泵。方法使用雄性 Sprague-Dawley 大鼠。研究了三种类型的胸部按压方法。单侧方法是用 2 个手指在胸骨上垂直进行的。2侧法用2个手指水平进行,双侧挤压胸壁。3边法结合了1边法和2边法。大鼠经历了 10 分钟的窒息性 CA。我们检查了 ROSC 率、左心室功能、几种动脉压、胸内压和脑组织氧含量。结果3侧组从窒息性CA中实现了100%的自主循环(ROSC)恢复,而1侧组和2侧组分别实现了80%和60%的ROSC。三侧胸外按压显着缩短组间ROSC时间(1侧,105±36.0;2侧,141±21.7;3侧,分别为57.8±12.3 s,P < 0.05)。三侧显着增加胸内压(食管,7.6±1.9,7.3±2.8,vs. 12.7±2.2;mmHg,P<0.01),心搏量(与基线的比值1.2±0.6,1.3±0.1,与 2.1 ± 0.6,P < 0.05)和颈总动脉压(减去股动脉压 4.0 ± 2.5、0.3 ± 1.6,与 8.4 ± 2.6;mmHg,P < 0.01)。三方显着增加脑组织含氧量(基线比值1.4±0.1、1.3±0.2、1.6±0.04,P < 0。
更新日期:2019-12-01
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