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Updated: May 17, 2025
Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine
Published on: January 30, 2020
Chest compression synchronized ventilation during prolonged experimental cardiopulmonary resuscitation improves
Jukka Kopra1, Lassi Mehtonen2, Merja Laitinen3
1Department of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Paciuksenkatu 1, 00290 Helsinki, Finland.
Background:
Chest compression synchronized ventilation (CCSV) has been proposed to provide superior ventilation and haemodynamics during cardiac arrest (CA) compared to conventional asynchronous ventilation and compressions. We compared arterial gas exchange, pH, lactate levels and haemodynamics between CCSV and manual asynchronous ventilation during prolonged experimental CA.
Methods:
We randomized 30 pigs (weight ca. 55 kg) to receive CCSV with a MEDUMAT Standard2 ventilator or a manual bag valve targeting 10-12 ventilations per minute. Chest compressions were provided with a Lucas® 2 device. Arterial samples were drawn every 5 min and monitoring was recorded continuously. The animals underwent chest CT scans after death.
Results:
The median intra-arrest arterial blood gas results for CCSV were PaO2 = 490 (86-570) mmHg, PaCO2 = 20 (10-35) mmHg and pH = 7.39 (7.19-7.53). In the manual ventilation group, the results were PaO2 = 304 (109-379), PaCO2 = 36 (28-47) and pH = 7.24 (7.12-7.34). The oxygen levels were significantly higher in the CCSV group compared to a linear mixed model (p = 0.046). The differences in CO2 and pH levels were not statistically significant. The minute volumes and positive end-expiratory pressures were higher in the CCSV (18.0 [15.3-19.8] l/min; 32.6 [29.2-35.6] cmH2O) group compared to the control group (5.7 [4.9-7.0] l/min; 2.8 [1.8-4.1] cmH2O). The CCSV group had 12 pneumothoraces compared to 3 in the control group (p = 0.008).
Conclusions:
The CCSV protocol resulted in higher arterial oxygenation but more pneumothoraces.The study was approved by the Finnish National Animal Experiment Board (ESAVI-26974-2023).
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