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10.1164/rccm.201407-1343OC

http://scihub22266oqcxt.onion/10.1164/rccm.201407-1343OC
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suck abstract from ncbi


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pmid25321490
      Am+J+Respir+Crit+Care+Med 2014 ; 190 (11 ): 1255-62
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  • Patient-centric blood pressure-targeted cardiopulmonary resuscitation improves survival from cardiac arrest #MMPMID25321490
  • Sutton RM ; Friess SH ; Naim MY ; Lampe JW ; Bratinov G ; Weiland TR 3rd ; Garuccio M ; Nadkarni VM ; Becker LB ; Berg RA
  • Am J Respir Crit Care Med 2014[Dec]; 190 (11 ): 1255-62 PMID25321490 show ga
  • RATIONALE: Although current resuscitation guidelines are rescuer focused, the opportunity exists to develop patient-centered resuscitation strategies that optimize the hemodynamic response of the individual in the hopes to improve survival. OBJECTIVES: To determine if titrating cardiopulmonary resuscitation (CPR) to blood pressure would improve 24-hour survival compared with traditional CPR in a porcine model of asphyxia-associated ventricular fibrillation (VF). METHODS: After 7 minutes of asphyxia, followed by VF, 20 female 3-month-old swine randomly received either blood pressure-targeted care consisting of titration of compression depth to a systolic blood pressure of 100 mm Hg and vasopressors to a coronary perfusion pressure greater than 20 mm Hg (BP care); or optimal American Heart Association Guideline care consisting of depth of 51 mm with standard advanced cardiac life support epinephrine dosing (Guideline care). All animals received manual CPR for 10 minutes before first shock. Primary outcome was 24-hour survival. MEASUREMENTS AND MAIN RESULTS: The 24-hour survival was higher in the BP care group (8 of 10) compared with Guideline care (0 of 10); P = 0.001. Coronary perfusion pressure was higher in the BP care group (point estimate +8.5 mm Hg; 95% confidence interval, 3.9-13.0 mm Hg; P < 0.01); however, depth was higher in Guideline care (point estimate +9.3 mm; 95% confidence interval, 6.0-12.5 mm; P < 0.01). Number of vasopressor doses before first shock was higher in the BP care group versus Guideline care (median, 3 [range, 0-3] vs. 2 [range, 2-2]; P = 0.003). CONCLUSIONS: Blood pressure-targeted CPR improves 24-hour survival compared with optimal American Heart Association care in a porcine model of asphyxia-associated VF cardiac arrest.
  • |*Practice Guidelines as Topic [MESH]
  • |*Precision Medicine [MESH]
  • |Animals [MESH]
  • |Blood Pressure/*drug effects [MESH]
  • |Cardiopulmonary Resuscitation/methods/*standards [MESH]
  • |Disease Models, Animal [MESH]
  • |Epinephrine/administration & dosage/*therapeutic use [MESH]
  • |Female [MESH]
  • |Heart Arrest/*therapy [MESH]
  • |Hemodynamics/physiology [MESH]
  • |Humans [MESH]
  • |Survival Analysis [MESH]
  • |Swine [MESH]


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