Academic Journal

Impact of tidal volume during cardiopulmonary resuscitation: an experimental pilot porcine study.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Impact of tidal volume during cardiopulmonary resuscitation: an experimental pilot porcine study.
Συγγραφείς: Lesimple A; Vent'Lab, Medical Intensive Care Unit, Angers University Hospital, Angers, France; Med(2)Lab Laboratory, Air Liquide Medical Systems, Antony, France., Richard JC; Vent'Lab, Medical Intensive Care Unit, Angers University Hospital, Angers, France; Med(2)Lab Laboratory, Air Liquide Medical Systems, Antony, France. Electronic address: jcmb.richard@gmail.com., Lidouren F; National Veterinary School of Alfort, IMRB, AfterROSC Network, 94700 Maisons-Alfort, France; University Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France., Watanabe N; National Veterinary School of Alfort, IMRB, AfterROSC Network, 94700 Maisons-Alfort, France; University Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France., Polard L; Vent'Lab, Medical Intensive Care Unit, Angers University Hospital, Angers, France; Med(2)Lab Laboratory, Air Liquide Medical Systems, Antony, France., Faucheux L; Sorbonne University, Paris, France., Bruneval P; Georges Pompidou European Hospital, AP-HP, Paris, France., Schmit H; Department of Emergency Medicine, Annecy Genevois Hospital, Annecy, France., Cordioli R; Vent'Lab, Medical Intensive Care Unit, Angers University Hospital, Angers, France; Med(2)Lab Laboratory, Air Liquide Medical Systems, Antony, France., Mercat A; Vent'Lab, Medical Intensive Care Unit, Angers University Hospital, Angers, France; Medical Intensive Care Unit, Angers University Hospital, Angers, France., Brochard L; Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada., Hutin A; National Veterinary School of Alfort, IMRB, AfterROSC Network, 94700 Maisons-Alfort, France; SAMU of Paris and Intensive Care Unit, Necker University Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris 75015, France., Tissier R; National Veterinary School of Alfort, IMRB, AfterROSC Network, 94700 Maisons-Alfort, France; University Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France.
Πηγή: Resuscitation [Resuscitation] 2026 Jun; Vol. 223, pp. 111062. Date of Electronic Publication: 2026 Mar 17.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier/north-Holland Biomedical Press Country of Publication: Ireland NLM ID: 0332173 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-1570 (Electronic) Linking ISSN: 03009572 NLM ISO Abbreviation: Resuscitation Subsets: MEDLINE
Imprint Name(s): Publication: Limerick : Elsevier/north-Holland Biomedical Press
Original Publication: London, Middlesex Pub. Co.
Ιατρικοί όροι (MeSH): Cardiopulmonary Resuscitation*/methods , Tidal Volume*/physiology , Ventricular Fibrillation*/therapy , Ventricular Fibrillation*/physiopathology , Heart Arrest*/therapy , Heart Arrest*/physiopathology, Respiration, Artificial/methods ; Animals ; Swine ; Pilot Projects ; Hemodynamics ; Capnography ; Disease Models, Animal ; Female
Περίληψη: Background: The optimal tidal volume (VT) during Cardio-Pulmonary Resuscitation (CPR) remains unknown. Capnogram could permit to detect ventilation induced harmful effect.
Objectives: The objectives of the present study were to describe the impact of different VT on hemodynamics during CPR; and to evaluate whether capnogram analysis can assess the influence of ventilation on circulation.
Methods: Eighteen pigs had five minutes of untreated ventricular fibrillation followed by CPR with automated continuous chest compressions and ventilation settings randomly combining VT 6, 10 or 14 ml/kg. Capnograms were recorded to determine thoracic distension patterns. After return of spontaneous circulation (ROSC), all surviving animals were ventilated 2 h and lungs were withdrawn for histological analysis.
Results: VT was associated with differences in the hemodynamic parameters studied. VT at 6 or 14 ml/kg graphically showed poorer cerebral and coronary perfusion pressures and mean arterial pressure than a VT at 10 ml/kg. The capnogram could distinguish three levels of thoracic distension. Thoracic distension was associated with differences in the hemodynamic parameters studied. Animals with either low or high distension showed poorer cerebral and coronary perfusion pressures and mean arterial pressure than those with moderate distension. ROSC was obtained in 13 (72%) animals. Histology showed that both low and high VT was associated with a trend towards higher lung damage.
Conclusions: In this animal study, a U-shaped relationship observed with VT suggests that both small and large VT may impair circulation. Capnogram analysis could contribute to identify ventilation settings associated with hemodynamic compromise.
(Copyright © 2026 The Author(s). Published by Elsevier B.V. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Arnaud Lesimple reports equipment, drugs, or supplies was provided by Air Liquide Medical Systems. Arnaud Lesimple reports a relationship with Med Lab – research laboratory within Air Liquide Medical Systems that includes: employment. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. AL is working in the Med2Lab funded by Air Liquide Medical Systems. JCR reports part time salary for research activities (Med2Lab) from Air Liquide Medical Systems and Vygon and grants from Creative Air Liquide. LP is working in the Med2Lab funded by Air Liquide Medical Systems. AM reports personal fees from Draeger, Faron Pharmaceuticals, Air Liquide Medical Systems, Pfizer, Resmed and Draeger and grants and personal fees from Fisher and Paykel and Covidien, outside this work. LB has received research grants for his research laboratory from Covidien (PAV), Draeger (EIT), and equipment from Fisher Paykel (high flow), Air Liquide, Sentec (PtcCO2) and Philips (sleep), and received fees for lectures from Fisher Paykel. RT reports grants from Air Liquide and grants, shares and personal fees from Orixha, all outside of this work. All other authors declare no competing interests.
Contributed Indexing: Keywords: Airway closure; CO(2) pattern; Capnogram; Cardiopulmonary resuscitation; Thoracic distension; Tidal volume
Entry Date(s): Date Created: 20260319 Date Completed: 20260711 Latest Revision: 20260711
Update Code: 20260711
DOI: 10.1016/j.resuscitation.2026.111062
PMID: 41856451
Βάση Δεδομένων: MEDLINE