Comparison between manual and mechanical chest compressions during resuscitation in a pediatric animal model of asphyxial cardiac arrest

PLoS One. 2017 Nov 30;12(11):e0188846. doi: 10.1371/journal.pone.0188846. eCollection 2017.

Abstract

Aims: Chest compressions (CC) during cardiopulmonary resuscitation are not sufficiently effective in many circumstances. Mechanical CC could be more effective than manual CC, but there are no studies comparing both techniques in children. The objective of this study was to compare the effectiveness of manual and mechanical chest compressions with Thumper device in a pediatric cardiac arrest animal model.

Material and methods: An experimental model of asphyxial cardiac arrest (CA) in 50 piglets (mean weight 9.6 kg) was used. Animals were randomized to receive either manual CC or mechanical CC using a pediatric piston chest compressions device (Life-Stat®, Michigan Instruments). Mean arterial pressure (MAP), arterial blood gases and end-tidal CO2 (etCO2) values were measured at 3, 9, 18 and 24 minutes after the beginning of resuscitation.

Results: There were no significant differences in MAP, DAP, arterial blood gases and etCO2 between chest compression techniques during CPR. Survival rate was higher in the manual CC (15 of 30 = 50%) than in the mechanical CC group (3 of 20 = 15%) p = 0.016. In the mechanical CC group there was a non significant higher incidence of haemorrhage through the endotracheal tube (45% vs 20%, p = 0.114).

Conclusions: In a pediatric animal model of cardiac arrest, mechanical piston chest compressions produced lower survival rates than manual chest compressions, without any differences in hemodynamic and respiratory parameters.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Asphyxia / complications*
  • Cardiopulmonary Resuscitation / methods*
  • Heart Arrest / etiology
  • Heart Arrest / therapy*
  • Swine

Grants and funding

This work was supported by Carlos III Health Institute (PI15/00743): Mother-Child Health and Development Network (Red SAMID) - RETICS funded by the PN I+D+I 2008-2011 (Spain), ISCIIISub-Directorate General for Research Assessment and Promotion and the European Regional Development Fund (ERDF), ref. RD16/0022/0007. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.