Comparison of 15:1, 15:2, and 30:2 Compression-to-Ventilation Ratios for Cardiopulmonary Resuscitation in a Canine Model of a Simulated, Witnessed Cardiac Arrest

Authors

  • Sung Oh Hwang MD,

    1. From the Wonju College of Medicine, Yonsei University (SOH, HK, YSJ, PGZ, KHL, HJC, TYS), Wonju, Kangwondo; and the Woolsan College of Medicine, Woolsan University (SHK), Woolsan, Republic of Korea.
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  • Sun Hyu Kim MD,

    1. From the Wonju College of Medicine, Yonsei University (SOH, HK, YSJ, PGZ, KHL, HJC, TYS), Wonju, Kangwondo; and the Woolsan College of Medicine, Woolsan University (SHK), Woolsan, Republic of Korea.
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  • Hyun Kim MD,

    1. From the Wonju College of Medicine, Yonsei University (SOH, HK, YSJ, PGZ, KHL, HJC, TYS), Wonju, Kangwondo; and the Woolsan College of Medicine, Woolsan University (SHK), Woolsan, Republic of Korea.
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  • Yong Soo Jang MD,

    1. From the Wonju College of Medicine, Yonsei University (SOH, HK, YSJ, PGZ, KHL, HJC, TYS), Wonju, Kangwondo; and the Woolsan College of Medicine, Woolsan University (SHK), Woolsan, Republic of Korea.
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  • Pei Ge Zhao MD,

    1. From the Wonju College of Medicine, Yonsei University (SOH, HK, YSJ, PGZ, KHL, HJC, TYS), Wonju, Kangwondo; and the Woolsan College of Medicine, Woolsan University (SHK), Woolsan, Republic of Korea.
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  • Kang Hyun Lee MD,

    1. From the Wonju College of Medicine, Yonsei University (SOH, HK, YSJ, PGZ, KHL, HJC, TYS), Wonju, Kangwondo; and the Woolsan College of Medicine, Woolsan University (SHK), Woolsan, Republic of Korea.
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  • Han Joo Choi MD,

    1. From the Wonju College of Medicine, Yonsei University (SOH, HK, YSJ, PGZ, KHL, HJC, TYS), Wonju, Kangwondo; and the Woolsan College of Medicine, Woolsan University (SHK), Woolsan, Republic of Korea.
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  • Tae Yong Shin MD

    1. From the Wonju College of Medicine, Yonsei University (SOH, HK, YSJ, PGZ, KHL, HJC, TYS), Wonju, Kangwondo; and the Woolsan College of Medicine, Woolsan University (SHK), Woolsan, Republic of Korea.
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Address for correspondence and reprints: Sung Oh Hwang, MD; e-mail: shwang@yonsei.ac.kr.

Abstract

Objectives:  This experimental study compared the effect of compression-to-ventilation (CV) ratios of 15:1, 15:2, and 30:2 on hemodynamics and resuscitation outcome in a canine model of a simulated, witnessed ventricular fibrillation (VF) cardiac arrest.

Methods:  Thirty healthy dogs, irrespective of species (mean ± SD, 19.2 ± 2.2 kg), were used in this study. A VF arrest was induced. The dogs received cardiopulmonary resuscitation (CPR) and were divided into three groups based on the applied CV ratios of 15:1, 15:2, and 30:2. After 1 minute of untreated VF, 4 minutes of basic life support (BLS) was performed. At the end of the 4 minutes, the dogs were defibrillated with an automatic external defibrillator (AED) and advanced cardiac life support (ACLS) efforts were continued for 10 minutes or until restoration of spontaneous circulation (ROSC) was attained, whichever came first.

Results:  None of the hemodynamic parameters, and arterial oxygen profiles was significantly different between the three groups during BLS- and ACLS-CPR. Eight dogs (80%) from each group achieved ROSC during BLS and ACLS. The survival rate was not different between the three groups. In the 15:1 and 30:2 groups, the number of compressions delivered over 1 minute were significantly greater than in the 15:2 group (73.1 ± 8.1 and 69.0 ± 6.9 to 56.3 ± 6.8; p < 0.01). The time for ventilation during which compressions were stopped at each minute was significantly lower in the 15:1 and 30:2 groups than in the 15:2 group (15.4 ± 3.9 and 17.1 ± 2.7 to 25.2 ± 2.6 sec/min; p < 0.01).

Conclusions:  In a canine model of witnessed VF using a simulated scenario, CPR with three CV ratios, 15:1, 15:2, and 30:2, did not result in any differences in hemodynamics, arterial oxygen profiles, and resuscitation outcome among the three groups. CPR with a CV ratio of 15:1 provided comparable chest compressions and shorter pauses for ventilation between each cycle compared to a CV ratio of 30:2.

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