Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model
Clinical and Experimental Emergency Medicine
;
(4): 250-256, 2019.
Article
in English
| WPRIM
| ID: wpr-785614
ABSTRACT
OBJECTIVE:
Head elevation at an angle of 30° during cardiopulmonary resuscitation (CPR) was hemodynamically beneficial compared to supine position in a previous porcine cardiac arrest experimental study. However, survival benefit of head-up elevation during CPR has not been clarified. This study aimed to assess the effect of head-up tilt position during CPR on 24-hour survival in a porcine cardiac arrest experimental model.METHODS:
This was a randomized experimental trial using female farm pigs (n=18, 42±3 kg) sedated, intubated, and paralyzed on a tilting surgical table. After surgical preparation, 15 minutes of untreated ventricular fibrillation was induced. Then, 6 minutes of basic life support was performed in a position randomly assigned to either head-up tilt at 30° or supine with a mechanical CPR device, LUCAS-2, and an impedance threshold device, followed by 20 minutes of advanced cardiac life support in the same position. Primary outcome was 24-hour survival, analyzed by Fisher exact test.RESULTS:
In the 8 pigs from the head-up tilt position group, one showed return of spontaneous circulation (ROSC); all eight pigs expired within 24 hours. In the eight pigs from the supine position group, six had the ROSC; six pigs survived for 24 hours and two expired. The head-up position group showed lower 24-hour survival rate and lower ROSC rate than supine position group (P<0.01).CONCLUSION:
The use of head-up tilt position with 30 degrees during CPR showed lower 24-hour survival than the supine position.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Swine
/
Ventricular Fibrillation
/
Survival Rate
/
Supine Position
/
Cardiopulmonary Resuscitation
/
Electric Impedance
/
Advanced Cardiac Life Support
/
Animal Experimentation
/
Agriculture
/
Head
Type of study:
Controlled clinical trial
Limits:
Female
/
Humans
Language:
English
Journal:
Clinical and Experimental Emergency Medicine
Year:
2019
Type:
Article
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