Nasopharyngeal oxygen with intermittent nose‐close and abdomen‐compression: A novel resuscitation technique in a piglet model

Objective: To evaluate the efficacy of a simple and novel cardiopulmonary resuscitation (CPR) technique, nasopharyngeal oxygen with intermittent nose‐close and abdomen‐compression (NPO 2 ‐NC‐AC) in an animal model. Design: Prospective piglet study. Setting: In an animal physiology laboratory of a medical university. Piglets: Six healthy piglets <14 days old. Interventions: Spontaneous breathing of the anesthetized piglets (n = 6) was medically ceased until severe bradycardia (<20 beat/min). NPO 2 ‐NC‐AC CPR trial was then initiated by delivering NPO 2 at 1.0–1.5 L/kg/min and intermittently performing the NC‐AC maneuver: (1) NC for inspiration, occluded nostrils for 1 sec; and (2) AC for expiration, released nostrils, and compressed the abdomen for 1 sec. NC‐AC was repeated at a rate of 30/min for 5 min. This CPR trial was repeated three times in each piglet. Cardiopulmonary variables were monitored, recorded, and compared. Measurements and Main Results: A total of 18 CPR trials were performed. All of these acute life‐threatening asphyxia events rapidly improved within 1 min of CPR. Cardiopulmonary variables recovered to the baseline levels and oxygenation continually increased. The intratracheal pressure (P tr ) values of positive end expiratory pressure and peak inspiratory pressure values were 4.3 ± 0.8 cmH 2 O and 26.2 ± 4.1 cmH 2 O, respectively. Chest wall movement was observed when the P tr reached 17.5 ± 3.1 cmH 2 O. All six piglets fully recovered after 63.8 ± 7.2 min of experiment without additional support. Conclusions: NPO 2 ‐NC‐AC is a simple and effective CPR technique for severe acute cardiopulmonary asphyxia in piglets. It may be clinically applicable for supportive or rescue use. Pediatr Pulmonol. 2013; 48:288–294. © 2012 Wiley Periodicals, Inc.