Author/Editor		Noč, M
Title		Vloga umetnega dihanja med kardiopulmonalnim oživljanjem
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		1994
Volume		str. 40
Language		slo
Abstract		Intermittent positive pressure ventilation was adopted as an essential component of cardiopulmonary resuscitation (CPR). This, however, is an empirical concept without unequivocal experimental evidence. Since pulmonary blood flow is reduced to less than one third of normal during CPR, we reasoned that adequate pulmonary ventilation may be maintained with precordial compression and spontaneous gasping such that additional positive pressure ventilation was not obligatory. To test for this hypothesis, a pig model of CPR was utilized. Ventricular fibrillation was induced in intubated domestic pigs. After 4 minutes of untreated ventricular fibrillation, precordial compression was begun. Each of 33 animals received one of three interventions in conjunction with precordial compression: positive pressure ventilation with 100 per cent oxygen (group A), 100 per cent oxygen (group B) or room air (group C), both supplied at the port of tracheal tube at ambient pressure. After 8 minutes of precordial compression, defibrillation was attempted. Cardiac resuscitability, 24 and 48-hour survival were comparable between the group A (7/11) and B (8/11). This contrasted with animals on room air (group C) of which only 3 of 11 were resuscitated (p less th. 0.05). No differences in post-resuscitation cardiac performance and pulmonary gas exchange were observed. Minute ventilation during precordial compression in the absence of positive pressure ventilation exceeded 5 l in the first minute and then progressively decreased to 3 to 4 l/minute. It was significantly lesser than in animals maintained on positive pressure ventilation. Arterial PCO2 increased to approximately 48 mm Hg in the absence of positive pressure ventilation. It was only 28 mm Hg in animals with ventilatory support (p less th. 0.05). With supplemental oxygen, arterial oxyhemoglobin saturation exceeded 90 per cent regardless of the presence of positive pressure ventilation.(trunc.)
Descriptors		RESPIRATION, ARTIFICIAL CARDIOPULMONARY RESUSCITATION HEART MASSAGE SWINE ANIMALS, DOMESTIC DISEASE MODELS, ANIMAL VENTRICULAR FIBRILLATION ELECTRIC COUNTERSHOCK BLOOD PRESSURE ELECTROCARDIOGRAPHY