Haemodynamic changes with varying chest compression rates in asphyxiated piglets

Background Current neonatal resuscitation guidelines recommend that chest compressions (CCs) be delivered at a rate of 90/min. The aim of the study was to investigate the haemodynamic effects of different CC rates in a neonatal piglet model. Methods Six asphyxiated piglets were randomised to CC with rates of 60/min, 90/min, 120/min, 150/min and 180/min for 1 min at each rate. CCs superimposed with sustained inflations were performed with an automated CC machine. Results Six newborn piglets (age 0-3 days, weight 2.0-2.3 kg) were included in the study. Overall, there was a gradual increase in stroke volume, minimum and maximum rate of left ventricle pressure change (dp/dt(min) and dp/dt(max)), and carotid blood flow until CC rate of 150/min, with a level-off effect at a CC rate of 180/min. However, cardiac output continued to increase with the highest being at a CC rate of 180/min. Conclusion Rate of CC was associated with changes in haemodynamic parameters during cardiopulmonary resuscitation. CC rate of 150-180/min during CC resulted in the highest cardiac output and arterial blood pressure. In this paper, the authors found that incremental increases in the rate of chest compressions up to 180/min improved cardiac output in asphyxiated piglets receiving cardiopulmonary resuscitation with sustained inflations.