10.6084/m9.figshare.5267782.v1 Li E.S. Li E.S. Görens I. Görens I. Cheung P.-Y. Cheung P.-Y. Lee T.-F. Lee T.-F. Lu M. Lu M. O'Reilly M. O'Reilly M. Schmölzer G.M. Schmölzer G.M. Supplementary Material for: Chest Compressions during Sustained Inflations Improve Recovery When Compared to a 3:1 Compression:Ventilation Ratio during Cardiopulmonary Resuscitation in a Neonatal Porcine Model of Asphyxia Karger Publishers 2017 Infants Newborns Neonatal resuscitation Chest compressions Sustained inflation Asphyxia 2017-08-02 12:11:53 Journal contribution https://karger.figshare.com/articles/journal_contribution/Supplementary_Material_for_Chest_Compressions_during_Sustained_Inflations_Improve_Recovery_When_Compared_to_a_3_1_Compression_Ventilation_Ratio_during_Cardiopulmonary_Resuscitation_in_a_Neonatal_Porcine_Model_of_Asphyxia/5267782 <p><b><i>Background:</i></b> Recently, sustained inflations (SI) during chest compression (CC) (CC+SI) have been suggested as an alternative to the current approach during neonatal resuscitation. No previous study compared CC+SI using CC rates of 90/min to the current 3:1 compression:ventilation ratio (C:V). <b><i>Objective:</i></b> To determine whether CC+SI versus a 3:1 C:V reduces the time to the return of spontaneous circulation (ROSC) and improves hemodynamic recovery in newborn piglets with asphyxia-induced bradycardia. <b><i>Intervention and Measurements:</i></b> Term newborn piglets were anesthetized, intubated, instrumented, and exposed to 45-min normocapnic hypoxia followed by asphyxia. Cardiopulmonary resuscitation (CPR) was initiated when the heart rate decreased to 25% of baseline. Piglets were randomized into 3 groups: CC during SI at a rate of 90 CC/min (SI+CC 90, <i>n</i> = 8), a 3:1 C:V using 90 CC and 30 inflations (3:1, <i>n</i> = 8), or a sham group (<i>n</i> = 6). Cardiac function, carotid blood flow, cerebral oxygenation, and respiratory parameters were continuously recorded throughout the experiment. <b><i>Results:</i></b> CC+SI significantly reduced the median (IQR) time of ROSC, i.e., 34 s (28-156 s) versus 210 s (72-300 s) in the 3:1 group (<i>p</i> = 0.048). CC+SI also significantly reduced the requirement for 100% oxygen, improved respiratory parameters, and resulted in a similar hemodynamic recovery. <b><i>Conclusions:</i></b> CC+SI during CPR significantly improved ROSC in a porcine model of neonatal resuscitation. This is of considerable clinical relevance because improved respiratory and hemodynamic parameters potentially minimize morbidity and mortality in newborn infants.</p>