Abstract 19: Effects of Stomach Inflation on Hemodynamic and Pulmonary Function During Cardiopulmonary Resuscitation in Pigs

Abstract

Background : Stomach inflation during cardiopulmonary resuscitation (CPR) is frequent. The purpose of this study was to evaluate effects of different levels of stomach inflation on hemodynamic and pulmonary function during CPR in a porcine model. Methods: After 4min of ventricular fibrillation, randomization to 0, 5, or 10L of stomach inflation was performed in 21 piglets. Basic life support CPR was then initiated for 3min, followed by a combination of epinephrine (45mcg/kg) and vasopressin (0.4U/kg) and defibrillation 2min later, and a post resuscitation phase of 30min. Kruskal-Wallis test was used for analysis; results are given as median (range). Results : During basic life support CPR, 0, 5, and 10L stomach inflation resulted in comparable coronary perfusion pressure between groups [10 (2–20), 8 (4–35), and 5 (0 –18) mmHg, respectively]. Increasing (0, 5, and 10L) stomach inflation resulted in significantly (P<.05) decreasing static pulmonary compliance [52 (38 –98), 19 (8 –32), and 12 (7–15) mL/cmH 2 O, respectively], and significantly increasing mean airway pressure during mechanical ventilation [14 (12–15), 26 (20 – 66), and 40 (13– 46) cmH 2 O]. Arterial partial pressure of oxygen was significantly higher with 0L when compared with 5 and 10L stomach inflation, but comparable between 5 and 10L stomach inflation [378 (88–440), 58 (47–113), and 54 (43–126) mmHg, respectively]. Similarly, arterial partial pressure of carbon dioxide was significantly lower with 0L when compared with 5 and 10L of stomach inflation [30 (24–36), 41(34 –51), and 56 (45– 68) mmHg, respectively]. Return of spontaneous circulation rates were comparable between groups [5/7 in 0L, 4/7 in 5L, and 3/7 in 10L stomach inflation]. Conclusion : In this CPR model, increasing levels of stomach inflation had adverse effects on pulmonary, but not on hemodynamic function.