339 Pro-Inflammatory Cytokines in Csf/Balf are Similar at Compression:Ventilation Ratio 15:2 Versus 3:1 in Asphyxiated Newborn Piglets with Cardiac Arrest

Abstract

Background and aim: The ideal ratio of chest compressions to ventilations (C:V ratio) during neonatal cardiopulmonary resuscitation (CPR) is unknown. The aim of the study was to investigate the C:V ratios of 15:2 and 3:1 in terms of time to return of spontaneous circulation (ROSC) and expression of pro-inflammatory cytokines in a piglet model of cardiac arrest following severe asphyxia.

Methods: Twenty two Noroc pigs (age 12-36 h) were anaesthetized and mechanically ventilated followed by progressive asphyxiation until asystole occurred. CPR was performed by positive pressure ventilation (21% O₂)cardiac compressions at a C:V ratio of 3:1 (n=11) or 15:2 (n=11). Protein concentrations of interleukin-1β (IL-1β) were measured in cerebrospinal fluid (CSF) and bronchoalveolar lavage fluid (BALF); and interleukin-8 (IL-8) and tumor necrosis factor-α (TNFα) were measured in BALF only using commercially available ELISA kits for porcine samples.

Results: Two of the animals in each group did not achieve ROSC after 15 minutes of CPR, and were excluded from the analyses. Mean time (SD) to ROSC for the 3:1 group was 204 s (153) and 250 s (144) for the 15:2 group (p=0.52). There was no difference between the two groups in any of the cytokines measured, neither in CSF nor in BALF. (Table will be included in poster).

Conclusion: Time to ROSC and expression of proinflammatory cytokines in the brain (CSF) and lungs (BALF) were comparable between groups possibly indicating that the C:V ratio of 15:2 is as safe and effective as 3:1.

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