EFFECT OF CHEST COMPRESSION RELEASE VELOCITY ON CEREBRAL PERFUSION PRESSURE IN PORCINE CARDIAC ARREST MODEL

Objective: High-quality cardiopulmonary resuscitation is crucial for the survival of patients experiencing cardiac arrest, but the effect of the chest compression release velocity (CCRV) has not been well studied. The aim of this study was to evaluate the effect of the CCRV on cerebral perfusion pressure (CePP) in an experimental study of porcine cardiac arrest. Methods: A ventricular fibrillation (VF)-induced experimental model of cardiac arrest was established in 16 pigs. The study subjects were randomized into a high-CCRV (400 mm/s) group and a low-CCRV (300 mm/s) group. Six minutes after VF induction, all the study subjects underwent 4 min of chest compression followed by 20 min of advanced cardiovascular life support, including the i.v. administration of epinephrine. Defibrillation was provided after 24 minutes of resuscitation. The primary outcome was CePP, which was calculated as the difference between the MAP and intracranial pressure. The Wilcoxon rank sum test was used to compare two groups in each resuscitation phase, and a linear mixed model was used to analyze the interaction effect of group and resuscitation phase. Results: Each of the eight subjects in the high-CCRV group and low-CCRV group were finally analyzed. The CEPP was highest at 10 to 12 min after VF in the low-CCRV group, with a mean (95% confidence interval) of 14.9 (0.2-29.7) mm Hg, and at 12 to 14 min after VF in the high-CCRV group, with a mean (95% confidence interval) of 18.2 (3.8-32.6) mm Hg. Compared with the low-CCRV group, the high-CCRV group had a greater CePP throughout the entire resuscitation phase, but there was no significant difference in the linear mixed model. Conclusion: In the porcine model of VF-induced cardiac arrest, there was a significant difference in CePP between the low-CCRV and high-CCRV groups. Further investigations should be performed to develop the resuscitation protocol to optimize brain perfusion.