• Heng Li, Lei Zhang, Zhengfei Yang, Zitong Huang, Bihua Chen, Yongqin Li, and Tao Yu.
• Emergency Department, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, China ; Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-Sen University, Guangzhou 510120, China ; Department of Emergency Medicine, Taiping People's Hospital, Medical School of Jinan University, Dongguan 523905, China.
• Biomed Res Int. 2013 Jan 1;2013:171862.

ObjectiveUntrained bystanders usually delivered suboptimal chest compression to victims who suffered from cardiac arrest in out-of-hospital settings. We therefore investigated the hemodynamics and resuscitation outcome of initial suboptimal quality of chest compressions compared to the optimal ones in a porcine model of cardiac arrest.MethodsFourteen Yorkshire pigs weighted 30 ± 2 kg were randomized into good and poor cardiopulmonary resuscitation (CPR) groups. Ventricular fibrillation was electrically induced and untreated for 6 mins. In good CPR group, animals received high quality manual chest compressions according to the Guidelines (25% of animal's anterior-posterior thoracic diameter) during first two minutes of CPR compared with poor (70% of the optimal depth) compressions. After that, a 120-J biphasic shock was delivered. If the animal did not acquire return of spontaneous circulation, another 2 mins of CPR and shock followed. Four minutes later, both groups received optimal CPR until total 10 mins of CPR has been finished.ResultsAll seven animals in good CPR group were resuscitated compared with only two in poor CPR group (P < 0.05). The delayed optimal compressions which followed 4 mins of suboptimal compressions failed to increase the lower coronary perfusion pressure of five non-survival animals in poor CPR group.ConclusionsIn a porcine model of prolonged cardiac arrest, even four minutes of initial poor quality of CPR compromises the hemodynamics and survival outcome.

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