{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T20:33:14Z","timestamp":1778099594521,"version":"3.51.4"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,10,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The American Heart Association recommends use of physiologic feedback when available to optimize chest compression delivery. We compared hemodynamic parameters during cardiopulmonary resuscitation in which either end\u2010tidal carbon dioxide (\n              <jats:styled-content style=\"fixed-case\">ETCO<\/jats:styled-content>\n              <jats:sub>2<\/jats:sub>\n              ) or diastolic blood pressure (\n              <jats:styled-content style=\"fixed-case\">DBP<\/jats:styled-content>\n              ) levels were used to guide chest compression delivery after asphyxial cardiac arrest.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              One\u2010 to 2\u2010week\u2010old swine underwent a 17\u2010minute asphyxial\u2010fibrillatory cardiac arrest followed by alternating 2\u2010minute periods of\n              <jats:styled-content style=\"fixed-case\">ETCO<\/jats:styled-content>\n              <jats:sub>2<\/jats:sub>\n              \u2010guided and\n              <jats:styled-content style=\"fixed-case\">DBP<\/jats:styled-content>\n              \u2010guided chest compressions during 10\u00a0minutes of basic life support and 10\u00a0minutes of advanced life support. Ten animals underwent resuscitation. We found significant changes to\n              <jats:styled-content style=\"fixed-case\">ETCO<\/jats:styled-content>\n              <jats:sub>2<\/jats:sub>\n              and\n              <jats:styled-content style=\"fixed-case\">DBP<\/jats:styled-content>\n              levels within 30\u00a0s of switching chest compression delivery methods. The overall mean\n              <jats:styled-content style=\"fixed-case\">ETCO<\/jats:styled-content>\n              <jats:sub>2<\/jats:sub>\n              level was greater during\n              <jats:styled-content style=\"fixed-case\">ETCO<\/jats:styled-content>\n              <jats:sub>2<\/jats:sub>\n              \u2010guided cardiopulmonary resuscitation (26.4\u00b15.6 versus 22.5\u00b15.2\u00a0mm Hg;\n              <jats:italic>P<\/jats:italic>\n              =0.003), whereas the overall mean\n              <jats:styled-content style=\"fixed-case\">DBP<\/jats:styled-content>\n              was greater during\n              <jats:styled-content style=\"fixed-case\">DBP<\/jats:styled-content>\n              \u2010guided cardiopulmonary resuscitation (13.9\u00b12.3 versus 9.4\u00b12.6\u00a0mm\u00a0Hg;\n              <jats:italic>P<\/jats:italic>\n              =0.003).\n              <jats:styled-content style=\"fixed-case\">ETCO<\/jats:styled-content>\n              <jats:sub>2<\/jats:sub>\n              \u2010guided chest compressions resulted in a faster compression rate (149\u00b13 versus 120\u00b15 compressions\/min;\n              <jats:italic>P<\/jats:italic>\n              =0.0001) and a higher intracranial pressure (21.7\u00b12.3 versus 16.0\u00b11.1\u00a0mm\u00a0Hg;\n              <jats:italic>P<\/jats:italic>\n              =0.002).\n              <jats:styled-content style=\"fixed-case\">DBP<\/jats:styled-content>\n              \u2010guided chest compressions were associated with a higher myocardial perfusion pressure (6.0\u00b12.8 versus 2.4\u00b13.2;\n              <jats:italic>P<\/jats:italic>\n              =0.02) and cerebral perfusion pressure (9.0\u00b13.0 versus 5.5\u00b14.3;\n              <jats:italic>P<\/jats:italic>\n              =0.047).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Using the\n              <jats:styled-content style=\"fixed-case\">ETCO<\/jats:styled-content>\n              <jats:sub>2<\/jats:sub>\n              or\n              <jats:styled-content style=\"fixed-case\">DBP<\/jats:styled-content>\n              level to optimize chest compression delivery results in physiologic changes that are method\u2010specific and occur within 30\u00a0s. Additional studies are needed to develop protocols for the use of these potentially conflicting physiologic targets to improve outcomes of prolonged cardiopulmonary resuscitation.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.009728","type":"journal-article","created":{"date-parts":[[2018,9,28]],"date-time":"2018-09-28T20:15:06Z","timestamp":1538165706000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Pilot Study to Compare the Use of End\u2010Tidal Carbon Dioxide\u2013Guided and Diastolic Blood Pressure\u2013Guided Chest Compression Delivery in a Swine Model of Neonatal Asphyxial Cardiac Arrest"],"prefix":"10.1161","volume":"7","author":[{"given":"Caitlin E.","family":"O'Brien","sequence":"first","affiliation":[{"name":"Department of Anesthesiology\/Critical Care Medicine Johns Hopkins University School of Medicine Baltimore 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