Neurologically Intact Survival in a Porcine Model of Cardiac Arrest: Manual Cardiopulmonary Resuscitation vs. LifeBelt Cardiopulmonary Resuscitation

Abstract

Objective. To compare the LifeBelt (Deca-Medica, Inc., Columbus, OH), a novel cardiopulmonary resuscitation (CPR) device, with manual CPR on the outcome of neurologically intact survival in a porcine model of cardiac arrest. Methods. Twenty-two adolescent swine were randomized by permuted block design to resuscitation using LifeBelt (n = 12) or manual CPR (n = 10). The animals were instrumented with right atrial and aortic pressure catheters while they were under general anesthesia with isoflurane and nitrous oxide. Ventricular fibrillation (VF) was induced with a bipolar pacing catheter placed in the right ventricle. After 7 minutes of untreated VF, chest compressions with either LifeBelt or manual CPR were initiated along with standard Advanced Cardiac Life Support. Survivors were assigned a neurologic score using the neurologic deficit score and the cerebral performance category (CPC) score at 24, 48, and 72 hours following resuscitation by a veterinarian blinded to treatment allocation. Results. There were no significant differences in prearrest hemodynamic parameters or in important resuscitation variables between the groups. One of 12 of the LifeBelt animals failed to achieve return of spontaneous circulation (0.08, 95% confidence interval [CI] 0.002–0.38). The remaining 11 had a neurologic deficit score of 0 and a CPC score of 1, indicating normal neurologic function. All of the manual CPR animals survived. One of 10 manual CPR survivors (0.10, 95% CI 0.003–0.45) had a neurologic deficit score of 260 and a CPC score of 3, indicating moderate disability, while the remaining animals had a neurologic deficit score of 0 and a CPC score of 1. Conclusions. In this porcine model of cardiac arrest, we did not detect significant differences in neurologically intact survival between LifeBelt CPR and manual CPR.

Key words: :

• heart arrest
• cardiopulmonary resuscitation
• ventricular fibrillation
• LifeBelt