TY - JOUR
T1 - Randomized trial of volume infusion during resuscitation of asphyxiated neonatal piglets
AU - Wyckoff, Myra
AU - Garcia, Damian
AU - Margraf, Linda
AU - Perlman, Jeffrey
AU - Laptook, Abbot
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2007/4
Y1 - 2007/4
N2 - Despite its use, there is little evidence to support volume infusion (VI) during neonatal cardiopulmonary resuscitation (CPR). This study compares 5% albumin (ALB), normal saline (NS), and no VI (SHAM) on development of pulmonary edema and restoration of mean arterial pressure (MAP) during resuscitation of asphyxiated piglets. Mechanically ventilated swine (n = 37, age: 8 ± 4 d, weight: 2.2 ± 0.7 kg) were progressively asphyxiated until pH <7.0, Paco2 >100 mm Hg, heart rate (HR) <100 bpm, and MAP <20 mm Hg. After 5 min of ventilatory resuscitation, piglets were randomized blindly to ALB, NS, or SHAM infusion. Animals were recovered for 2 h before euthanasia and lung tissue sampled for wet-to-dry weight ratio (W/D) as a marker of pulmonary edema. SHAM MAP was similar to VI during resuscitation. At 2 h post-resuscitation, MAP of SHAM (48 ± 13 mm Hg) and ALB (43 ± 19 mm Hg) was higher than NS (29 ± 10 mm Hg; p = 0.003 and 0.023, respectively). After resuscitation, SHAM piglets had less pulmonary edema (W/D: 5.84 ± 0.12 versus 5.98 ± 0.19; p = 0.03) and better dynamic compliance (Cd) compared with ALB or NS (Cd: 1.43 ± 0.69 versus 0.97 ± 0.37 mL/cm H2O, p = 0.018). VI during resuscitation did not improve MAP, and acute recovery of MAP was poorer with NS compared with ALB. VI was associated with increased pulmonary edema. In the absence of hypovolemia, VI during neonatal resuscitation is not beneficial.
AB - Despite its use, there is little evidence to support volume infusion (VI) during neonatal cardiopulmonary resuscitation (CPR). This study compares 5% albumin (ALB), normal saline (NS), and no VI (SHAM) on development of pulmonary edema and restoration of mean arterial pressure (MAP) during resuscitation of asphyxiated piglets. Mechanically ventilated swine (n = 37, age: 8 ± 4 d, weight: 2.2 ± 0.7 kg) were progressively asphyxiated until pH <7.0, Paco2 >100 mm Hg, heart rate (HR) <100 bpm, and MAP <20 mm Hg. After 5 min of ventilatory resuscitation, piglets were randomized blindly to ALB, NS, or SHAM infusion. Animals were recovered for 2 h before euthanasia and lung tissue sampled for wet-to-dry weight ratio (W/D) as a marker of pulmonary edema. SHAM MAP was similar to VI during resuscitation. At 2 h post-resuscitation, MAP of SHAM (48 ± 13 mm Hg) and ALB (43 ± 19 mm Hg) was higher than NS (29 ± 10 mm Hg; p = 0.003 and 0.023, respectively). After resuscitation, SHAM piglets had less pulmonary edema (W/D: 5.84 ± 0.12 versus 5.98 ± 0.19; p = 0.03) and better dynamic compliance (Cd) compared with ALB or NS (Cd: 1.43 ± 0.69 versus 0.97 ± 0.37 mL/cm H2O, p = 0.018). VI during resuscitation did not improve MAP, and acute recovery of MAP was poorer with NS compared with ALB. VI was associated with increased pulmonary edema. In the absence of hypovolemia, VI during neonatal resuscitation is not beneficial.
UR - http://www.scopus.com/inward/record.url?scp=34147092655&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34147092655&partnerID=8YFLogxK
U2 - 10.1203/pdr.0b013e3180332c45
DO - 10.1203/pdr.0b013e3180332c45
M3 - Article
C2 - 17515864
AN - SCOPUS:34147092655
SN - 0031-3998
VL - 61
SP - 415
EP - 420
JO - Pediatric Research
JF - Pediatric Research
IS - 4
ER -