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A proof-of-concept study evaluating cardiac compression techniques for cardiopulmonary resuscitation in laying hens
Jessica Eisenbarth1, Charles O Cummings2, Elizabeth A Rozanski1
1Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA.
Insights
In chickens with ventricular fibrillation, sternal compressions with interposed caudal coelomic compressions (ICCC) generated higher arterial pressures than lateral compressions (LC). Sternal compressions (SC) alone showed no significant difference from the other techniques.
Area of Science:
- Veterinary Medicine
- Comparative Physiology
- Emergency Medicine
Background:
- Cardiopulmonary resuscitation (CPR) techniques are crucial for emergency care.
- Evaluating CPR efficacy in avian models is essential for comparative research.
- Direct arterial pressure measurement provides accurate hemodynamic assessment.
Purpose of the Study:
- To compare the effectiveness of three CPR techniques in adult chickens.
- To determine which technique yields the highest systolic, diastolic, and mean arterial pressure.
- To assess the impact of sternal compressions (SC), SC with interposed caudal coelomic compressions (ICCC), and lateral compressions (LC) on arterial pressure.
Main Methods:
- A prospective, nonblinded, experimental crossover study was conducted in a laboratory setting.
- Ten adult chickens underwent induced ventricular fibrillation.
- Three different CPR techniques (SC, ICCC, LC) were applied randomly for 2 minutes each, with direct carotid artery pressure monitoring.
Main Results:
- ICCC resulted in significantly higher systolic (27.6 ± 5.3 mm Hg), diastolic (18.7 ± 5.2 mm Hg), and mean arterial pressure (21.7 ± 5.2 mm Hg) compared to LC.
- SC (SAP: 24.5 ± 6.4, DAP: 15.2 ± 4.3, MAP: 18.3 ± 5.0 mm Hg) did not show significant differences compared to ICCC or LC.
- LC produced the lowest arterial pressures (SAP: 18.9 ± 5.4, DAP: 11.6 ± 4.1, MAP: 14.1 ± 4.5 mm Hg).
Conclusions:
- External cardiac compressions can elevate arterial pressure in chickens experiencing ventricular fibrillation.
- ICCC is a more effective technique than LC for generating higher arterial pressures in this model.
- SC alone is comparable to ICCC in its ability to generate arterial pressure, but LC is less effective.
Objective:
To determine in adult chickens which of 3 CPR techniques, sternal compressions (SC), SC with interposed caudal coelomic compressions (ICCC), or lateral compressions (LC), results in the highest mean systolic (SAP), diastolic (DAP), and mean arterial pressure (MAP) as measured directly from the carotid artery.
Design:
Prospective, nonblinded, experimental crossover study.
Setting:
University teaching hospital laboratory.
Animals:
Ten retired laying hens.
Interventions:
Birds were sedated, anesthetized, and placed in dorsal recumbency. A carotid artery catheter was placed to directly measure arterial pressure. Ventricular fibrillation was induced with direct cardiac stimulation using a 9-Volt battery. Each bird then received 2 minutes of the 3 different cardiac compression techniques in a random order by 3 different compressors, with the compressor order also randomized. Birds were subsequently administered IV epinephrine, and transthoracic defibrillation was attempted. At the end of experimentation, each bird was euthanized, and simple gross necropsies were performed. Linear mixed models followed by pairwise paired t-tests were performed to evaluate differences in pressures generated by each technique.
Measurements And Main Results:
The primary study outcomes were SAP, DAP, and MAP over 2 minutes of compressions for each compression technique. Pressures from ICCC (SAP: 27.6 ± 5.3 mm Hg, DAP: 18.7 ± 5.2 mm Hg, MAP: 21.7 ± 5.2 mm Hg) were significantly higher than those from LC (SAP: 18.9 ± 5.4 mm Hg, DAP: 11.6 ± 4.1 mm Hg, MAP: 14.1 ± 4.5 mm Hg). Pressures from SC (SAP: 24.5 ± 6.4 mm Hg, DAP: 15.2 ± 4.3 mm Hg, MAP: 18.3 ± 5.0 mm Hg) were not significantly different from ICCC or LC.
Conclusions:
External compressions can generate detectable increases in arterial pressure in chickens with ventricular fibrillation. SC with ICCC generated significantly higher arterial pressures than LC. SC alone generated blood pressures that were not significantly different from those generated by SC with ICCC or LC.
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