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- W1991898984 abstract "S149 Introduction: External chest compression (ECC) is performed as part of CPR efforts in order to assure (some) circulation despite cardiac arrest. There is no agreement about the best way to perform external chest compression nor about the mechanism by which circulation is induced during ECC. However, all providers of CPR and ECC would agree, that ECC is a demanding task in terms of physical resources. Indeed, enough manpower to perform the procedures is i.a. one of the determinants of success or failure. Hypothesis: Sequentially and separately ventilating the two lung halves (inspiration-left after expiration-right) assures sufficient horizontal heart displacement to induce adequate systemic pressure oscillations (blood flow) during cardiac arrest. Purpose of the study: To establish in an animal model (miniature pig) whether this novell method of squeezing the heart with minimal energy consumption for the CPR provider assures adequate systemic blood pressure and flow (test the validity of the hypotesis). Material & Methods: Two male mini-pigs fasted for 12 h were premedicated with Sufentanil on sugar cubes. After adequate sedation 400 mg Ketamine + 2 mg Flunitrazepam were given i.m. The animals were weighed and the ear vein was cannulated (ID 1 mm). After pre-oxygenation by mask Alcuronium 10 mg, Lidocaine 50 mg, and Fentanyl 0.15 mg were given i.v.. The animals were orotracheally intubated with a ID 7.0 tube and mechanically ventilated to achieve normocapnia. Additional relaxant and opiate were given as needed. Monitoring: BP continuous (carotid), CVP (internal jugular), capnometry, pulseoximetry, arterial and venous blood gases, hematocrit (Hct). The trachea was surgically exposed just above the notch, the tracheal tube removed, an horizontal incision was performed and the animals were bronchially intubated with two identical tubes (ID 5.0). The left endobronchial tube was connected to an Ambu-Bag; the right endobronchial tube was connected to the Siemens 900 C ventilator. The ventilator provided to the right lung a tidal volume of 400 ml at a rate of 20 cycles/minute. The peak pressure limit of the machine was set at 40 mm Hg. After expiration from the right lung the bag was squeezed to ventilate the left lung. At his point the animals were sacrificed with i.v.-application of KCl. As soon as a flat-line ECG was seen ([similar] 12 sec) conventional ECC CPR was instituted. 6 volunteers performed ECC. Results: The blood pressure registered with ECC was in all cases systolic above 90 (best 110) and diastolic above 40 (best 62). After ECC being stopped the sequential lung ventilation produced a blood pressure (mm Hg) at maximal inspiration of around 60 and a blood pressure after expiration of around 40. Variations of tidal volume and cycle rate could not increase the pressure difference or the absolute value. Conclusion: Sequentially and separately ventilating the two lung halves does not induce adequate systemic pressure oscillations (blood flow) during cardiac arrest." @default.
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- W1991898984 date "1998-02-01" @default.
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- W1991898984 title "SEQUENTIAL VENTILATION OF THE TWO LUNG HALVES IN MINIPIGS" @default.
- W1991898984 doi "https://doi.org/10.1097/00000539-199802001-00148" @default.
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