Nasopharyngeal oxygen with intermittent nose-close and abdomen-compression: a novel resuscitation technique in a
Wen-Jue Soong1, Mei-Jy Jeng, Yu-Sheng Lee
1Department of Pediatrics, Children's Medical Center, Taipei Veterans General Hospital, Taipei, Taiwan. wjsoong@vghtpe.gov.tw
Objective:
To evaluate the efficacy of a simple and novel cardiopulmonary resuscitation (CPR) technique, nasopharyngeal oxygen with intermittent nose-close and abdomen-compression (NPO(2) -NC-AC) in an animal model.
Design:
Prospective piglet study.
Setting:
In an animal physiology laboratory of a medical university. PIGLETS: Six healthy piglets <14 days old.
Interventions:
Spontaneous breathing of the anesthetized piglets (n = 6) was medically ceased until severe bradycardia (<20 beat/min). NPO(2) -NC-AC CPR trial was then initiated by delivering NPO(2) at 1.0-1.5 L/kg/min and intermittently performing the NC-AC maneuver: (1) NC for inspiration, occluded nostrils for 1 sec; and (2) AC for expiration, released nostrils, and compressed the abdomen for 1 sec. NC-AC was repeated at a rate of 30/min for 5 min. This CPR trial was repeated three times in each piglet. Cardiopulmonary variables were monitored, recorded, and compared.
Measurements And Main Results:
A total of 18 CPR trials were performed. All of these acute life-threatening asphyxia events rapidly improved within 1 min of CPR. Cardiopulmonary variables recovered to the baseline levels and oxygenation continually increased. The intratracheal pressure (P(tr) ) values of positive end expiratory pressure and peak inspiratory pressure values were 4.3 ± 0.8 cmH(2) O and 26.2 ± 4.1 cmH(2) O, respectively. Chest wall movement was observed when the P(tr) reached 17.5 ± 3.1 cmH(2) O. All six piglets fully recovered after 63.8 ± 7.2 min of experiment without additional support.
Conclusions:
NPO(2) -NC-AC is a simple and effective CPR technique for severe acute cardiopulmonary asphyxia in piglets. It may be clinically applicable for supportive or rescue use.
