Cardiopulmonary resuscitation: effect of CPAP on gas exchange during chest compressions.

Abstract:

BACKGROUND:Conventional cardiopulmonary resuscitation (CPR) includes 80-100/min precordial compressions with intermittent positive pressure ventilation (IPPV) after every fifth compression. To prevent gastric insufflation, chest compressions are held during IPPV if the patient is not intubated. Elimination of IPPV would simplify CPR and might offer physiologic advantages, but compression-induced ventilation without IPPV has been shown to result in hypercapnia. The authors hypothesized that application of continuous positive airway pressure (CPAP) might increase CO2 elimination during chest compressions. METHODS:After appropriate instrumentation and measurement of baseline data, ventricular fibrillation was induced in 18 pigs. Conventional CPR was performed as a control (CPR(C)) for 5 min. Pauses were then discontinued, and animals were assigned randomly to receive alternate trials of uninterrupted chest compressions at a rate of 80/min without IPPV, either at atmospheric airway pressure (CPR(ATM)) or with CPAP (CPR(CPAP)). CPAP was adjusted to produce a minute ventilation of 75% of the animal's baseline ventilation. Data were summarized as mean +/- SD and compared with Student t test for paired observations. RESULTS:During CPR without IPPV, CPAP decreased PaCO2 (55+/-28 vs. 100+/-16 mmHg) and increased SaO2 (0.86+/-0.19 vs. 0.50+/-0.18%; P < 0.001). CPAP also increased arteriovenous oxygen content difference (10.7+/-3.1 vs. 5.5+/-2.3 ml/dl blood) and CO2 elimination (120+/-20 vs. 12+/-20 ml/min; P < 0.01). Differences between CPR(CPAP) and CPR(ATM) in aortic blood pressure, cardiac output, and stroke volume were not significant. CONCLUSIONS:Mechanical ventilation may not be necessary during CPR as long as CPAP is applied. Discontinuation of IPPV will simplify CPR and may offer physiologic advantage.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Hevesi ZG,Thrush DN,Downs JB,Smith RA

doi

10.1097/00000542-199904000-00022

subject

Has Abstract

pub_date

1999-04-01 00:00:00

pages

1078-83

issue

4

eissn

0003-3022

issn

1528-1175

journal_volume

90

pub_type

杂志文章
  • Recovery, psychomotor skills, and simulated driving after brief inhalational anesthesia with halothane or enflurane combined with nitrous oxide and oxygen.

    abstract::Recovery from anesthesia was assessed in a controlled manner in 34 healthy student volunteers, using a psychomotor test battery 1 and 5 hours and a driving simulator 2, 4.5, and 7 hours after 3.5 minutes of anesthesia with halothane or enflurane combined with nitrous oxide and oxygen. Psychomotor performances remained...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197701000-00006

    authors: Korttila K,Tammisto T,Ertama P,Pfäffli P,Blomgren E,Häkkinen S

    更新日期:1977-01-01 00:00:00

  • Halothane effects on ATP content and uridine uptake and phosphorylation in Tetrahymena pyriformis.

    abstract::The effects of halothane on uptake and phosphorylation of uridine, and on cellular ATP content were studied in Tetrahymena pyriformis, a ciliate protozoan. Exposure to halothane inhibited the accumulation of 14C-uridine into the following acid-soluble intracellular pools: UTP, UDP, UMP, and an unidentified compound. H...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:

    authors: Conklin KA,Lau SS

    更新日期:1984-07-01 00:00:00

  • Isoflurane prevents delayed cell death in an organotypic slice culture model of cerebral ischemia.

    abstract:BACKGROUND:General anesthetics reduce neuronal death caused by focal cerebral ischemia in rodents and by in vitro ischemia in cultured neurons and brain slices. However, in intact animals, the protective effect may enhance neuronal survival for only several days after an ischemic injury, possibly because anesthetics pr...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200201000-00033

    authors: Sullivan BL,Leu D,Taylor DM,Fahlman CS,Bickler PE

    更新日期:2002-01-01 00:00:00

  • Dexamethasone changes brain monoamine metabolism and aggravates ischemic neuronal damage in rats.

    abstract:BACKGROUND:Glucocorticoids have been reported to aggravate ischemic brain damage. Because changes in the activities of various neuronal systems are closely related to the outcome of ischemic damage, the authors evaluated the effects of dexamethasone on the monoaminergic systems and ischemic neuronal damage. METHODS:Th...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199902000-00028

    authors: Tsubota S,Adachi N,Chen J,Yorozuya T,Nagaro T,Arai T

    更新日期:1999-02-01 00:00:00

  • Prognostic significance of blood lactate and lactate clearance in trauma patients.

    abstract:BACKGROUND:Lactate has been shown to be a prognostic biomarker in trauma. Although lactate clearance has already been proposed as an intermediate endpoint in randomized trials, its precise role in trauma patients remains to be determined. METHODS:Blood lactate levels and lactate clearance (LC) were calculated at admis...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e318273349d

    authors: Régnier MA,Raux M,Le Manach Y,Asencio Y,Gaillard J,Devilliers C,Langeron O,Riou B

    更新日期:2012-12-01 00:00:00

  • Administration of nitrous oxide to pediatric patients provides analgesia for venous cannulation.

    abstract::To determine whether administration of nitrous oxide, 50% and 70%, could provide analgesia and anxiolysis during venous cannulation in pediatric patients, 165 ASA Physical Status 1 patients scheduled for elective surgery were studied. Children, 3 weeks to 18 yr of age, were randomly assigned either to receive nitrous ...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199002000-00010

    authors: Henderson JM,Spence DG,Komocar LM,Bonn GE,Stenstrom RJ

    更新日期:1990-02-01 00:00:00

  • Prostacyclin regulates spinal nociceptive processing through cyclic adenosine monophosphate-induced translocation of glutamate receptors.

    abstract:BACKGROUND:Prostacyclin (PGI2) is known to be an important mediator of peripheral pain sensation (nociception) whereas little is known about its role in central sensitization. METHODS:The levels of the stable PGI2-metabolite 6-keto-prostaglandin F1α (6-keto-PGF1α) and of prostaglandin E2 (PGE2) were measured in the do...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3182a76f74

    authors: Schuh CD,Brenneis C,Zhang DD,Angioni C,Schreiber Y,Ferreiros-Bouzas N,Pierre S,Henke M,Linke B,Nüsing R,Scholich K,Geisslinger G

    更新日期:2014-02-01 00:00:00

  • Midazolam potentiates nociceptive behavior, sensitizes cutaneous reflexes, and is devoid of sedative action in neonatal rats.

    abstract:BACKGROUND:The significant postnatal maturation of gamma-aminobutyric acid signaling in the developing brain is likely to have important implications for infant pain processing. Gamma-aminobutyric acid receptor activation evokes analgesia and sedation in the adult, but the impact of immature gamma-aminobutyric acid sig...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/01.anes.0000296079.45446.15

    authors: Koch SC,Fitzgerald M,Hathway GJ

    更新日期:2008-01-01 00:00:00

  • Cumulative duration of "triple low" state of low blood pressure, low bispectral index, and low minimum alveolar concentration of volatile anesthesia is not associated with increased mortality.

    abstract:BACKGROUND:Mortality after noncardiac surgery has been associated with the "triple low state," a combination of low mean arterial blood pressure (<75 mmHg), low bispectral index (<45), and low minimum alveolar concentration of volatile anesthesia (<0.70). The authors set out to determine whether duration of a triple lo...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000281

    authors: Kertai MD,White WD,Gan TJ

    更新日期:2014-07-01 00:00:00

  • Hemodynamic interactions of verapamil and isoflurane.

    abstract::The hemodynamic interactions of verapamil and isoflurane were studied in eight dogs. Left ventricular function was analyzed using a right heart bypass preparation to permit rigid hemodynamic control. Hemodynamic studies were performed at 0.7, 1.05, and 1.40% isoflurane before and during the maintenance of two stable l...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198308000-00012

    authors: Kates RA,Kaplan JA,Guyton RA,Dorsey L,Hug CC Jr,Hatcher CR

    更新日期:1983-08-01 00:00:00

  • Anesthetic techniques for fetal surgery: effects of maternal anesthesia on intraoperative fetal outcomes in a sheep model.

    abstract:BACKGROUND:Use of high-dose inhalational anesthesia during open fetal surgery may induce maternal-fetal hemodynamic instability and fetal myocardial depression. The authors' preliminary human retrospective study demonstrated less fetal bradycardia and left ventricular systolic dysfunction with lower dose desflurane sup...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e318283c954

    authors: Ngamprasertwong P,Michelfelder EC,Arbabi S,Choi YS,Statile C,Ding L,Boat A,Eghtesady P,Holland K,Sadhasivam S

    更新日期:2013-04-01 00:00:00

  • Pharmacodynamic Interaction of Remifentanil and Dexmedetomidine on Depth of Sedation and Tolerance of Laryngoscopy.

    abstract:BACKGROUND:Dexmedetomidine is a sedative with modest analgesic efficacy, whereas remifentanil is an opioid analgesic with modest sedative potency. Synergy is often observed when sedative-hypnotics are combined with opioid analgesics in anesthetic practice. A three-phase crossover trial was conducted to study the pharma...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/ALN.0000000000002882

    authors: Weerink MAS,Barends CRM,Muskiet ERR,Reyntjens KMEM,Knotnerus FH,Oostra M,van Bocxlaer JFP,Struys MMRF,Colin PJ

    更新日期:2019-11-01 00:00:00

  • Accelerometry of adductor pollicis muscle predicts recovery of respiratory function from neuromuscular blockade.

    abstract:BACKGROUND:Residual paralysis increases the risk of pulmonary complications but is difficult to detect. To test the hypothesis that accelerometry predicts effects of residual paralysis on pulmonary and upper airway function, the authors related tests of pulmonary and pharyngeal function to accelerometry of adductor pol...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000542-200306000-00006

    authors: Eikermann M,Groeben H,Hüsing J,Peters J

    更新日期:2003-06-01 00:00:00

  • The effect of propofol on isolated human pregnant uterine muscle.

    abstract:BACKGROUND:Propofol is an alternative to thiopental as an intravenous induction agent for cesarean section. Because it has relaxant effects on vascular and other smooth muscles, the authors set out to determine whether propofol has any effect on pregnant human uterine smooth muscle in an isolated preparation. METHODS:...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199807000-00017

    authors: Shin YK,Kim YD,Collea JV

    更新日期:1998-07-01 00:00:00

  • Forebrain HCN1 channels contribute to hypnotic actions of ketamine.

    abstract:BACKGROUND:Ketamine is a commonly used anesthetic, but the mechanistic basis for its clinically relevant actions remains to be determined. The authors previously showed that HCN1 channels are inhibited by ketamine and demonstrated that global HCN1 knockout mice are twofold less sensitive to hypnotic actions of ketamine...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e318287b7c8

    authors: Zhou C,Douglas JE,Kumar NN,Shu S,Bayliss DA,Chen X

    更新日期:2013-04-01 00:00:00

  • Evaluation of acupuncture anesthesia: a psychophysical study.

    abstract::Four volunteers judged eight levels of thermal stimuli induced by a Hardy dolorimeter, varying in intensity from extremely painful to a low level seldom even perceived. Half of the 406 stimuli were applied during acupuncture and half either before insertion or after removal of the needles. The experimental design mini...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197511000-00005

    authors: Day RL,Kitahata LM,Kao FF,Motoyama EK,Hardy JD

    更新日期:1975-11-01 00:00:00

  • A simplified gas chromatographic method for quantifying the sevoflurane metabolite hexafluoroisopropanol.

    abstract:BACKGROUND:The results of sevoflurane biotransformation (fluoromethyl-1,1,1,3,3,3,-hexafluoro-2-propyl ether) to inorganic fluoride have been examined. However, these investigations have lacked a simplified assay for determining the primary organic metabolite, hexafluoroisopropanol. Previous attempts have involved exte...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199401000-00027

    authors: Morgan SE,Frink EJ,Gandolfi AJ

    更新日期:1994-01-01 00:00:00

  • Risk Factors for Failure to Rescue in Myocardial Infarction after Noncardiac Surgery.

    abstract:BACKGROUND:Compared to other perioperative complications, failure to rescue (i.e., death after suffering a complication) is highest after perioperative myocardial infarction (a myocardial infarction that occurs intraoperatively or within 30 days after surgery). The purpose of this study was to identify patient and surg...

    journal_title:Anesthesiology

    pub_type: 杂志文章,多中心研究

    doi:10.1097/ALN.0000000000003330

    authors: Mazzarello S,McIsaac DI,Beattie WS,Fergusson DA,Lalu MM

    更新日期:2020-07-01 00:00:00

  • Capsaicin sensitive afferents contribute to acute airway edema following tracheal instillation of hydrochloric acid or gastric juice in the rat.

    abstract::The formation of acute edema in the tracheobronchial mucosa following local instillation of hydrochloric acid or gastric juice was studied in rats. Protein extravasation using the Evans blue technique was measured and used to indicate edema formation. A pH dependent Evans blue extravasation was observed whereby pH 2 p...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198803000-00005

    authors: Martling CR,Lundberg JM

    更新日期:1988-03-01 00:00:00

  • Using process analysis to assess the impact of medical education on the delivery of pain services: a natural experiment.

    abstract:BACKGROUND:The medical, social, and economic effects of the teaching mission on delivery of care at an academic medical center (AMC) are not fully understood. When a free-standing private practice ambulatory clinic with no teaching mission was merged into an AMC, a natural experiment was created. The authors compared p...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e31824a88d0

    authors: Williams KA,Chambers CG,Dada M,Hough D,Aron R,Ulatowski JA

    更新日期:2012-04-01 00:00:00

  • Effect of parecoxib, a novel intravenous cyclooxygenase type-2 inhibitor, on the postoperative opioid requirement and quality of pain control.

    abstract:BACKGROUND:The analgesic efficacy and side effect profile of intravenous parecoxib, a novel cyclooxygenase type-2 (COX-2) inhibitor, was assessed in a double-blinded, placebo-controlled study involving patients undergoing major gynecologic surgical procedures. METHODS:After Institutional Review Board approval, 60 cons...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200206000-00007

    authors: Tang J,Li S,White PF,Chen X,Wender RH,Quon R,Sloninsky A,Naruse R,Kariger R,Webb T,Norel E

    更新日期:2002-06-01 00:00:00

  • Inhaled anesthetics alter the determinants of coronary collateral blood flow in the dog.

    abstract:BACKGROUND:Whether coronary steal is induced by inhaled anesthetic agents remains controversial in part because multiple factors determine collateral blood flow. METHODS:We used an established model to determine how halothane, isoflurane, and desflurane affect the hemodynamic determinants of coronary collateral blood ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199510000-00020

    authors: Mignella R,Buffington CW

    更新日期:1995-10-01 00:00:00

  • Concentration-effect relation of succinylcholine chloride during propofol anesthesia.

    abstract:BACKGROUND:The pharmacokinetics and pharmacodynamics of succinylcholine were studied simultaneously in anesthetized patients to understand why the drug has a rapid onset and short duration of action. A quantitative model describing the concentration-effect relation of succinylcholine was proposed. The correlation betwe...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200211000-00009

    authors: Roy JJ,Donati F,Boismenu D,Varin F

    更新日期:2002-11-01 00:00:00

  • Can we trust the direct radial artery pressure immediately following cardiopulmonary bypass?

    abstract::Reversal of the usual relationship between aortic and radial artery pressure can occur in patients following cardiopulmonary bypass. Radial systolic (and often radial mean) pressures were lower, relative to aortic pressure, after cardiopulmonary bypass than before bypass in all 18 patients studied. The systolic pressu...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198505000-00002

    authors: Stern DH,Gerson JI,Allen FB,Parker FB

    更新日期:1985-05-01 00:00:00

  • Isoflurane provides long-term protection against focal cerebral ischemia in the rat.

    abstract:BACKGROUND:Long-term neuroprotection by isoflurane has been questioned. The authors examined factors in experimental models potentially critical to definition of enduring isoflurane neuroprotection. METHODS:Rats were prepared for temporary middle cerebral artery occlusion (MCAO). Pericranial normothermia was maintaine...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200701000-00017

    authors: Sakai H,Sheng H,Yates RB,Ishida K,Pearlstein RD,Warner DS

    更新日期:2007-01-01 00:00:00

  • Comparative analgesic and mental effects of increasing plasma concentrations of dexmedetomidine and alfentanil in humans.

    abstract:BACKGROUND:In animals, systemic and intrathecal administration of the alpha2 -adrenergic receptor agonist dexmedetomidine results in robust antinociceptive effects in models of heat pain. In humans, systemically administered dexmedetomidine is approved for sedating patients in the intensive care unit. However, whether ...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200409000-00024

    authors: Angst MS,Ramaswamy B,Davies MF,Maze M

    更新日期:2004-09-01 00:00:00

  • Thiopental alters contraction, intracellular Ca2+, and pH in rat ventricular myocytes.

    abstract:BACKGROUND:Myocardial contractility is regulated by intracellular concentration of free Ca2+ ([Ca2'],) and myofilament Ca2+ sensitivity. The objective of this study was to elucidate the direct effects of thiopental on cardiac excitation-contraction coupling using individual, field-stimulated ventricular myocytes. METH...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199807000-00027

    authors: Kanaya N,Zakhary DR,Murray PA,Damron DS

    更新日期:1998-07-01 00:00:00

  • Cerebral and systemic effects of hypotension induced by adenosine or ATP in dogs.

    abstract::The authors evaluated the systemic and cerebral hemodynamic and metabolic effects of 1 h of hypotension to a mean arterial pressure of either 50 mmHg or 40 mmHg induced by intravenous adenosine or ATP in dogs maintained on 70% nitrous oxide and 0.1% halothane. Following the hypotensive period, brain biopsy specimens w...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198504000-00010

    authors: Newberg LA,Milde JH,Michenfelder JD

    更新日期:1985-04-01 00:00:00

  • Effect of 1.5% Topical Diclofenac on Clinical Neuropathic Pain.

    abstract:BACKGROUND:Neuropathic pain is a condition resulting from injury to the peripheral and/or central nervous system. Despite extensive research over the last several decades, neuropathic pain remains difficult to manage. METHODS:The authors conducted a randomized, placebo-controlled, double-blinded, and crossover clinica...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0000000000000693

    authors: Ahmed SU,Zhang Y,Chen L,Cohen A,St Hillary K,Vo T,Houghton M,Mao J

    更新日期:2015-07-01 00:00:00

  • Morphine inhibits spontaneous and cytokine-enhanced natural killer cell cytotoxicity in volunteers.

    abstract:BACKGROUND:Opioids are used by patients who have conditions ranging from the acute pain of surgery and chronic cancer pain to substance abuse. Despite their widespread use and considerable experimental data about them, little is known about how opioids may alter in vivo immunity in humans. This study was designed to ev...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199509000-00008

    authors: Yeager MP,Colacchio TA,Yu CT,Hildebrandt L,Howell AL,Weiss J,Guyre PM

    更新日期:1995-09-01 00:00:00