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BioMed Research International
Volume 2013, Article ID 171862, 6 pages
http://dx.doi.org/10.1155/2013/171862
Research Article

Even Four Minutes of Poor Quality of CPR Compromises Outcome in a Porcine Model of Prolonged Cardiac Arrest

1Emergency Department, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, China
2Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-Sen University, Guangzhou 510120, China
3Department of Emergency Medicine, Taiping People’s Hospital, Medical School of Jinan University, Dongguan 523905, China
4Emergency Department, Southwest Hospital of the Third Military Medical University, Chongqing 400038, China
5School of Biomedical Engineering, Third Military Medical University and Chongqing University, Chongqing 400038, China

Received 4 October 2013; Accepted 9 November 2013

Academic Editor: Giuseppe Ristagno

Copyright © 2013 Heng Li et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Untrained bystanders usually delivered suboptimal chest compression to victims who suffered from cardiac arrest in out-of-hospital settings. We therefore investigated the hemodynamics and resuscitation outcome of initial suboptimal quality of chest compressions compared to the optimal ones in a porcine model of cardiac arrest. Methods. Fourteen Yorkshire pigs weighted 30 ± 2 kg were randomized into good and poor cardiopulmonary resuscitation (CPR) groups. Ventricular fibrillation was electrically induced and untreated for 6 mins. In good CPR group, animals received high quality manual chest compressions according to the Guidelines (25% of animal’s anterior-posterior thoracic diameter) during first two minutes of CPR compared with poor (70% of the optimal depth) compressions. After that, a 120-J biphasic shock was delivered. If the animal did not acquire return of spontaneous circulation, another 2 mins of CPR and shock followed. Four minutes later, both groups received optimal CPR until total 10 mins of CPR has been finished. Results. All seven animals in good CPR group were resuscitated compared with only two in poor CPR group ( ). The delayed optimal compressions which followed 4 mins of suboptimal compressions failed to increase the lower coronary perfusion pressure of five non-survival animals in poor CPR group. Conclusions. In a porcine model of prolonged cardiac arrest, even four minutes of initial poor quality of CPR compromises the hemodynamics and survival outcome.