• Anne L Solevåg, Ingrid Dannevig, Myra Wyckoff, Ola D Saugstad, and Britt Nakstad.
• Department of Paediatrics, Akershus University Hospital, 1478 Lørenskog and Department of Paediatric Research, Oslo University Hospital, Rikshospitalet, 0027 Oslo, Norway. a.l.solevag@medisin.uio.no
• Arch. Dis. Child. Fetal Neonatal Ed. 2011 Nov 1;96(6):F417-21.

ObjectiveInternational guidelines recommend a compression to ventilation (C:V) ratio of 3:1 in neonates, and 15:2 for other paediatric age groups. The authors aimed to compare these two C:V ratios in a neonatal swine model of cardiac arrest following asphyxia.DesignExperimental animal study.SettingFacility for animal research.Subjects22 newborn pigs (age 12-36 h, weight 2.0-2.7 kg).InterventionsProgressive asphyxia until asystole. Animals were randomised to receive C:V 3:1 (n=11) or 15:2 (n=11).Main Outcome MeasuresReturn of spontaneous circulation (ROSC) was defined as a heart rate ≥ 100 bpm. Also of interest were haemodynamic parameters, cerebral and systemic oxygen saturation and the proinflammatory cytokine interleukin-1β (IL-1β).ResultsTwo animals in each group did not achieve ROSC. Mean (SD) increase in diastolic blood pressure (DBP; mm Hg) during compression cycles was significantly higher at a C:V ratio of 15:2 than 3:1 (7.1 (2.8) vs 4.8 (2.6)). Median time (IQR) to ROSC for the 3:1 group was 150 (140-180) s, and 195 (145-358) s for the 15:2 group. There were no significant differences in the temporal changes in haemodynamic parameters or oxygen saturation indices between the groups. IL-1β levels in cerebrospinal and bronchoalveolar lavage fluid was comparable between the groups.ConclusionIn neonatal pigs with asphyxia-induced cardiac arrest, the response to a C:V ratio of 15:2 is not better than the response to a C:V ratio of 3:1 despite better generation of DBP during resuscitation.

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