Compression-only CPR does not increase intracranial pressure compared to compression-ventilation CPR in pigs
Bibliographic record
Abstract
Introduction: Recent guidelines recommend compression-only CPR for bystander response to witnessed cardiac arrest although hypoventilation/apnoea may cause increase of intracranial pressure (ICP) affecting cerebral circulation.1Sayre M.R. Berg R.A. Cave D.M. Page R.L. Potts J. White R.D. American Heart Association Emergency Cardiovascular Care Committee. Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: a science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee.Circulation. 2008; 117: 2162-2167Crossref PubMed Scopus (317) Google Scholar, 2van Hulst R.A. Hasan D. Lachmann B. Intracranial pressure, brain PCO2, PO2, and pH during hypo- and hyperventilation at constant mean airway pressure in pigs.Intens Care Med. 2002; 28: 68-73Crossref PubMed Scopus (48) Google Scholar However, gasping respirations and chest compressions may generate some gas exchange.3Deakin C.D. O’Neill J.F. Tabor T. Does compression-only cardiopulmonary resuscitation generate adequate passive ventilation during cardiac arrest?.Resuscitation. 2007; 75: 53-59Abstract Full Text Full Text PDF PubMed Scopus (107) Google Scholar The aim of the study was to assess ICP during different means of CPR (no-CPR vs. compression-only CPR vs. compression-ventilation CPR) in a porcine model of ventricular fibrillation (VF). We hypothesized that compression-only CPR would increase ICP compared to compression-ventilation CPR if gasping was not present. Methods: Thirty-one anaesthetized domestic pigs (32 ± 2 kg) were included. ICP was measured via intraparenchymal probe MicroSensor Transducer (Codman, USA). Cerebral perfusion pressure was calculated according to the formula CPP = MAP − (ICP + CVP). VF was induced using intra-cardiac pacing lead. After 5 min of untreated VF, chest compressions were provided using an AutoPulse (Zoll, USA) simulating compression-only CPR for 5 min, followed with compression-ventilation CPR 30:2 for the next 5 min. Gasping was prevented using muscle relaxants. Data were analyzed using repeated measurements ANOVA and a Fisher's protected LSD post hoc test. Results: Intracranial pressure (mean ± SD) during pre-arrest period, untreated VF, compression-only CPR, and compression-ventilation CPR was 9.7 ± 5.6, 14.6 ± 4.9, 11.2 ± 4.5, and 11.7 ± 4.5 mmHg respectively. Cerebral perfusion pressure measured in the same periods was 55.5 ± 12.3, −13.1 ± 5.2, 17.8 ± 5.1, and 19.0 ± 4.1 mmHg respectively. There were no statistical differences between periods of compression-only CPR and compression–ventilation CPR (P = 0.31 for ICP, and P = 0.53 for cerebral perfusion pressure). Conclusion: Withholding ventilation during compression-only CPR did not cause any changes to intracerebral and cerebral perfusion pressures compared to compression–ventilation CPR in this porcine model of VF. Supported by a grant IGA MH CZ NS10383-2/2009 and a research project MZO 00179906.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".