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Femoral artery collapse ratio as an indicator of chest compression quality during cardiopulmonary resuscitation in a porcine cardiac arrest model
1Department of Emergency Medicine, Pusan National University School of Medicine, 50612 Busan, Republic of Korea
DOI: 10.22514/sv.2023.102 Vol.19,Issue 6,November 2023 pp.67-72
Submitted: 08 December 2022 Accepted: 01 March 2023
Published: 08 November 2023
*Corresponding Author(s): Ji Ho Ryu E-mail: pnuem@pusan.ac.kr
Cardiopulmonary resuscitation (CPR) quality is crucial for improving patient survival rates after cardiac arrest. This study aimed to investigate the usefulness of femoral artery collapse ratio (systolic diameter/diastolic diameter ratio) measurement using M-mode ultrasound versus end-tidal carbon dioxide (ETCO2) for the assessment of high-quality CPR in a porcine cardiac arrest model. A total of 10 male mongrel pigs (age range, 16–20 weeks; weight, 45–50 kg) were used. After anesthesia, the carotid artery was dissected and exposed. The animals were instrumented with an arterial catheter in the exposed carotid artery to monitor arterial blood pressure. Cardiac arrest was induced by injecting potassium chloride (KCl, 40 equivalents of weight). The animals underwent chest compression using a mechanical device, and the chest compression depth and ETCO2 were measured using a defibrillator. To obtain hemodynamic information, two investigators performed an ultrasound examination on both femoral arteries. One examiner measured the femoral peak systolic velocity (PSV), while the other measured the diameters of the femoral artery (systolic diameter and diastolic diameter) in a transverse or longitudinal position using the M-mode of the linear ultrasound probe. As the compression depth increased, ETCO2, femoral artery diameter, collapse ratio (systolic diameter/diastolic diameter), and blood flow increased; however, PSV decreased. The ETCO2 and collapse ratio were positively correlated. The femoral artery collapse ratio, measured using the M-mode ultrasound, could be an alternative and simple method to evaluate high-quality CPR.
Porcine; Ultrasound; Chest compression; Carbon dioxide; Cardiopulmonary resuscitation
Mun Ki Min,Dae Sup Lee,Min Jee Lee,Mo Se Chun,Seung Woo Shon,Tae Kyu Hyun,Ji Ho Ryu. Femoral artery collapse ratio as an indicator of chest compression quality during cardiopulmonary resuscitation in a porcine cardiac arrest model. Signa Vitae. 2023. 19(6);67-72.
[1] Merchant RM, Topjian AA, Panchal AR, Cheng A, Aziz K, Berg KM, et al. Part 1: Executive summary: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020; 142: S337–S357.
[2] Soar J, Böttiger BW, Carli P, Couper K, Deakin CD, Djärv T, et al. European resuscitation council guidelines 2021: adult advanced life support. Resuscitation. 2021; 161: 115–151.
[3] Link MS, Berkow LC, Kudenchuk PJ, Halperin HR, Hess EP, Moitra VK, et al. Part 7: Adult advanced cardiovascular life support: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015; 132: S444–S464.
[4] Sandroni C, De Santis P, D’Arrigo S. Capnography during cardiac arrest. Resuscitation. 2018; 132: 73–77.
[5] Weil MH, Bisera J, Trevino RP, Rackow EC. Cardiac output and end-tidal carbon dioxide. Critical Care Medicine. 1985; 13: 907–909.
[6] Sanders AB, Atlas M, Ewy GA, Kern KB, Bragg S. Expired PCO2 as an index of coronary perfusion pressure. The American Journal of Emergency Medicine. 1985; 3: 147–149.
[7] Lewis LM, Stothert J, Standeven J, Chandel B, Kurtz M, Fortney J. Correlation of end-tidal CO2 to cerebral perfusion during CPR. Annals of Emergency Medicine. 1992; 21: 1131–1134.
[8] Kolar M, Križmarić M, Klemen P, Grmec S. Partial pressure of end-tidal carbon dioxide successful predicts cardiopulmonary resuscitation in the field: a prospective observational Study. Critical Care. 2008; 12: R115.
[9] Sheak KR, Wiebe DJ, Leary M, Babaeizadeh S, Yuen TC, Zive D, et al. Quantitative relationship between end-tidal carbon dioxide and CPR quality during both in-hospital and out-of-hospital cardiac arrest. Resuscitation. 2015; 89: 149–154.
[10] Murphy RA, Bobrow BJ, Spaite DW, Hu C, McDannold R, Vadeboncoeur TF. Association between prehospital CPR quality and end-tidal carbon dioxide levels in out-of-hospital cardiac arrest. Prehospital Emergency Care. 2016; 20: 369–377.
[11] Touma O, Davies M. The prognostic value of end tidal carbon dioxide during cardiac arrest: a systematic review. Resuscitation. 2013; 84: 1470–1479.
[12] Ryu DH, Jung YH, Jeung KW, Lee BK, Jeong YW, Yun JG, et al. Effect of one-lung ventilation on end-tidal carbon dioxide during cardiopulmonary resuscitation in a pig model of cardiac arrest. PLOS ONE. 2018; 13: e0195826.
[13] Ölander C, Vikholm P, Lindblom R, Schiller P, Hellgren L. Extracorporeal cardiopulmonary resuscitation guided by end-tidal carbon dioxide—a porcine model. Journal of Cardiovascular Translational Research. 2022; 15: 291–301.
[14] Ölander C, Vikholm P, Schiller P, Hellgren L. End-tidal carbon dioxide impacts brain and kidney injury in experimental extracorporeal cardiopulmonary resuscitation (ECPR). Shock. 2021; 55: 563–569.
[15] Javaudin F, Her S, Le Bastard Q, De Carvalho H, Le Conte P, Baert V, et al. Maximum value of end-tidal carbon dioxide concentrations during resuscitation as an indicator of return of spontaneous circulation in out-of-hospital cardiac arrest. Prehospital Emergency Care. 2020; 24: 478–484.
[16] O’Brien CE, Santos PT, Kulikowicz E, Adams S, Lee JK, Hunt EA, et al. Use of an end-tidal carbon dioxide-guided algorithm during cardiopulmonary resuscitation improves short-term survival in paediatric swine. Resuscitation Plus. 2021; 8: 100174.
[17] Ruiz de Gauna S, Gutiérrez JJ, Ruiz J, Leturiondo M, Azcarate I, González-Otero DM, et al. The impact of ventilation rate on end-tidal carbon dioxide level during manual cardiopulmonary resuscitation. Resuscitation. 2020; 156: 215–222.
[18] Stengel D, Leisterer J, Ferrada P, Ekkernkamp A, Mutze S, Hoenning A. Point-of-care ultrasonography for diagnosing thoracoabdominal injuries in patients with blunt trauma. Cochrane Database of Systematic Reviews. 2018; 12: CD012669.
[19] Stickles SP, Carpenter CR, Gekle R, Kraus CK, Scoville C, Theodoro D, et al. The diagnostic accuracy of a point-of-care ultrasound protocol for shock etiology: a systematic review and meta-analysis. CJEM. 2019; 21: 406–417.
[20] Reynolds JC, Nicholson T, O’Neil B, Drennan IR, Issa M, Welsford M. Diagnostic test accuracy of point-of-care ultrasound during cardiopulmonary resuscitation to indicate the etiology of cardiac arrest: a systematic review. Resuscitation. 2022; 172: 54–63.
[21] Koch M, Mueller M, Warenits AM, Holzer M, Spiel A, Schnaubelt S. Carotid artery ultrasound in the (peri-)arrest setting—a prospective pilot study. Journal of Clinical Medicine. 2022; 11:469.
[22] Adedipe AA, Fly DL, Schwitz SD, Jorgenson DB, Duric H, Sayre MR, et al. Carotid doppler blood flow measurement during cardiopulmonary resuscitation is feasible: a first in man study. Resuscitation. 2015; 96: 121–125.
[23] Yilmaz G, Silcan M, Serin S, Caglar B, Erarslan Ö, Parlak İ. A comparison of carotid doppler ultrasonography and capnography in evaluating the efficacy of CPR. The American Journal of Emergency Medicine. 2018; 36: 1545–1549.
[24] Schwartz BE, Gandhi P, Najafali D, Gregory MM, Jacob N, Helberg T, et al. Manual palpation vs. femoral arterial doppler ultrasound for comparison of pulse check time during cardiopulmonary resuscitation in the emergency department: a pilot study. the Journal of Emergency Medicine. 2021; 61: 720–730.
[25] Olasveengen TM, Semeraro F, Ristagno G, Castren M, Handley A, Kuzovlev A, et al. European resuscitation council guidelines 2021: basic life support. Resuscitation. 2021; 161: 98–114.
[26] Liang L, Li Z, Chen R, Liu S, Zhou T, Jiang L, et al. Compression depth of 30 mm has similar efficacy and fewer complications versus 50 mm during mechanical chest compression with miniaturized chest compressor in a porcine model of cardiac arrest. Journal of Thoracic Disease. 2021; 13: 5788–5798.
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