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Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model

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 aim...

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Autores principales: Park, Yong Joo, Hong, Ki Jeong, Shin, Sang Do, Kim, Tae Yun, Ro, Young Sun, Song, Kyoung Jun, Ryu, Hyun Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Emergency Medicine 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6774013/
https://www.ncbi.nlm.nih.gov/pubmed/31571441
http://dx.doi.org/10.15441/ceem.18.060
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author Park, Yong Joo
Hong, Ki Jeong
Shin, Sang Do
Kim, Tae Yun
Ro, Young Sun
Song, Kyoung Jun
Ryu, Hyun Ho
author_facet Park, Yong Joo
Hong, Ki Jeong
Shin, Sang Do
Kim, Tae Yun
Ro, Young Sun
Song, Kyoung Jun
Ryu, Hyun Ho
author_sort Park, Yong Joo
collection PubMed
description 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.
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spelling pubmed-67740132019-10-09 Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model Park, Yong Joo Hong, Ki Jeong Shin, Sang Do Kim, Tae Yun Ro, Young Sun Song, Kyoung Jun Ryu, Hyun Ho Clin Exp Emerg Med Original Article 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. The Korean Society of Emergency Medicine 2019-09-30 /pmc/articles/PMC6774013/ /pubmed/31571441 http://dx.doi.org/10.15441/ceem.18.060 Text en Copyright © 2019 The Korean Society of Emergency Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).
spellingShingle Original Article
Park, Yong Joo
Hong, Ki Jeong
Shin, Sang Do
Kim, Tae Yun
Ro, Young Sun
Song, Kyoung Jun
Ryu, Hyun Ho
Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model
title Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model
title_full Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model
title_fullStr Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model
title_full_unstemmed Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model
title_short Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model
title_sort worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6774013/
https://www.ncbi.nlm.nih.gov/pubmed/31571441
http://dx.doi.org/10.15441/ceem.18.060
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