Abstract
BackgroundMechanical chest compression devices are accepted alternatives for cardiopulmonary resuscitation (CPR) under specific circumstances. Current devices lack prospective and comparative data on their specific cardiovascular effects and potential for severe thoracic injuries.ObjectivesTo compare CPR effectiveness and thoracic injuries of two mechanical chest compression devices in pigs.Study designProspective randomised trial.AnimalsEighteen male German landrace pigs.MethodsVentricular fibrillation was induced in anaesthetised and instrumented pigs and the animals were randomised into two intervention groups. Mechanical CPR was initiated by means of LUCAS™ 2 (mCCD1) or Corpuls™ cpr (mCCD2) device. Advanced life support was applied for a maximum of 10 cycles and animals achieving ROSC were monitored for 8 h. Ventilation/perfusion measurements were performed and blood gas analyses were taken. Thoracic injuries were assessed via a standardised damage score.ResultsFive animals of the mCCD1 group and one animal of the mCCD2 group achieved ROSC (p = 0.048). Only the mCCD1 animals survived until the end of the monitoring period (p < 0.01). MCCD1 animals showed less pulmonary shunt (p = 0.025) and higher normal V/Q (p = 0.017) during CPR. MCCD2 animals showed significantly more severe thoracic injuries (p = 0.046).ConclusionThe LUCAS 2 device shows superior resuscitation outcomes and less thoracic injuries compared to Corpuls cpr when used for experimental CPR in juvenile pigs. Researchers should be aware that different mCCDs for experimental studies may significantly influence the respective outcome of resuscitation studies and affect comparability of different trials. Controlled human and animal CPR studies and a standardised post-resuscitation injury evaluation could help to confirm potential hazards.Trial registrationTrial approval number: G16–1-042-E4.
Highlights
Mechanical chest compression devices are accepted alternatives for cardiopulmonary resuscitation (CPR) under specific circumstances
Mechanical CPR was initiated by means of Lund University cardiac arrest system (LUCASTM) 2 or CorpulsTM cpr device
The mCCD1 animals survived until the end of the monitoring period (p < 0.01)
Summary
Mechanical chest compression devices are accepted alternatives for cardiopulmonary resuscitation (CPR) under specific circumstances. Current devices lack prospective and comparative data on their specific cardiovascular effects and potential for severe thoracic injuries. Mechanical chest compression devices (mCCDs) have been increasingly implemented into clinical and out-ofhospital emergency care over the past 2 decades [1, 2]. The predominantly electric devices can be able to facilitate continuous and high-quality cardiopulmonary resuscitation (CPR) and provide adequate organ perfusion under cardiac arrest even during prolonged patient transport and when confronted with limited provider resources [3, 4]. Since the last ERC guideline update in 2015, another piston-mounted compression device, the CorpulsTM cpr has been approved for medical use, but currently lacks detailed prospective assessment [10,11,12]
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