NRP or PALS during CardioPulmonary Resuscitation in infantile piglets

Comparing Cardiopulmonary Resuscitation Techniques in Infantile Piglets: 3:1 Compression

vs. Continuous Compression with Asynchronized Ventilation

In the area of neonatal and pediatric resuscitation, the debate between different approaches to ventilation and chest compression continues to evolve. Our recent study aimed to compare the effectiveness of two such techniques—3:1 Compression (3:1 C:V) and Continuous Compression with Asynchronized Ventilation (CCaV)—during infant cardiopulmonary resuscitation (CPR) in infantile piglets.

Background and Hypothesis

To evaluate which resuscitation technique is superior, we hypothesized that the 3:1 C:V ratio would lead to a faster return of spontaneous circulation (ROSC) compared to CCaV in infantile piglets experiencing asphyxia-induced bradycardic cardiac arrest.

Methods

Our study involved twenty infantile piglets, aged 5-10 days, who were anesthetized and asphyxiated by clamping the endotracheal tube. The piglets were randomly assigned to receive resuscitation using either the 3:1 C:V or CCaV method (n = 10 per group). We continuously monitored various parameters including heart rate, arterial blood pressure, carotid blood flow, cerebral oxygenation, and respiratory metrics throughout the experiment.

Results

The findings revealed that the median time to ROSC for survivors was 157 seconds (IQR: 113-219) for the 3:1 C:V group compared to 421 seconds (IQR: 118-660) for the CCaV group (p = 0.253). The total duration of resuscitation was also similar, with 3:1 C:V lasting 206 seconds (IQR: 119-660) versus 660 seconds (IQR: 212-660) for CCaV (p = 0.171). The number of piglets achieving ROSC was comparable between the two groups: 7 out of 10 for 3:1 C:V and 6 out of 10 for CCaV (p = 1.00). Additionally, there were no significant differences in hemodynamic and respiratory parameters between the two methods.

Conclusions

Our study concluded that there is no significant difference in the time to ROSC or survival rates between the 3:1 C:V and CCaV techniques in infantile piglets. Both approaches appear equally viable for infantile CPR.

Impact

The results suggest that both 3:1 C:V ratio and CCaV are reasonable options for infant cardiopulmonary resuscitation, with no clear advantage of one method over the other in terms of ROSC time or survival. This study highlights a lack of definitive scientific data to guide specific recommendations on transitioning between neonatal and pediatric resuscitation guidelines. As such, either method remains a viable choice during infant CPR.

This research adds valuable insights into the ongoing discussion about the most effective resuscitation techniques for infants and underscores the need for further studies to refine and enhance resuscitation protocols.

this article received an editorial - to read here