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The effects of cardiopulmonary resuscitation under the diaphragmatic muscle on post-resuscitation hemodynamics after cardiac arrest in rabbit models

The aim of this study was to compare standard cardiopulmonary resuscitation (S-CPR) and diaphragmatic muscle cardiopulmonary resuscitation (D-CPR) for cardiac arrest (CA) in rabbit models. Twenty rabbits were randomized into either the S-CPR group or the D-CPR group. CA lasting 8 min was induced in healthy New Zealand rabbits through abdominal operation and tracheal tube clamping. During end-expiration 5 min after vital signs stabilized, the aortic pressure and transcutaneous oxygen saturation levels were recorded, and restoration of spontaneous circulation (ROSC) and the 6-h survival rate were analyzed. Five rabbits in the S-CPR group and eight in the D-CPR group achieved ROSC; the survival rate in the S-CPR group and the D-CPR group was 40% and 50%, respectively. Blood pressure indices in each group were higher post-ROSC than at baseline. One minute after resuscitation, the blood pressure values in the D-CPR group were higher than those in the S-CPR group (aortic systolic pressure=54.9 ± 10.1 mmHg versus 42.1 ± 16.2 mmHg, respectively; aortic diastolic pressure=22.1 ± 7.4 mmHg versus 15.1 ± 7.3 mmHg, respectively; mean arterial pressure=33.0 ± 5.8 mmHg versus 21.4 ± 8.5 mmHg, respectively; and coronary perfusion pressure=17.5 ± 7.5 mmHg versus 9.2 ± 6.6 mmHg, respectively). Five minutes after resuscitation, blood pressure values in the D-CPR group remained statistically higher than those in the S-CPR group. However, no differences between the two groups existed after 5 min. When compared to S-CPR, D-CPR resulted in a higher ROSC rate and a higher survival rate in rabbit models; however, the results depend on higher atrial pressure and cardiac output.

Author(s): Xiaogong Guo, Lixiang Wang, Guirong Yang, Chunxia Ding, Xu Li, Caihong Gu, Weiwei Dou, Jie Zhang