Ventilation with 18, 21, or 100% Oxygen during Cardiopulmonary Resuscitation of Asphyxiated Piglets: A Randomized Controlled Animal Trial

Neonatology. 2020;117(1):102-110. doi: 10.1159/000504494. Epub 2020 Jan 2.

Abstract

Background: In previous piglet experiments of profound asphyxia and cardiac arrest, recovery was similar when 21 and 100% oxygen were used for positive pressure ventilation (PPV). There was no consistent reduction in inflammation and oxidative stress in piglets ventilated with 21 or 100% oxygen.

Objectives: We aimed to investigate hypoxic resuscitation, i.e., PPV with 18% oxygen, in profoundly asphyxiated piglets with cardiac arrest. We hypothesized that resuscitation with 18% oxygen would result in less inflammation and oxidative stress compared to 21 or 100% oxygen.

Method: Twenty-four piglets were exposed to 30 min of normocapnic hypoxia followed by asphyxia until asystole. The piglets were randomized to PPV with 18% oxygen (n = 8), 21% oxygen (n = 8), or 100% oxygen (n = 8), and resuscitated with chest compressions and intravenous epinephrine. Return of spontaneous circulation (ROSC) was defined as an unassisted heart rate ≥100 bpm for 15 s. Lactate, GSH (total glutathione), GSSG (oxidized glutathione), and GSSG/GSH ratio were measured in myocardial and frontoparietal cortex homogenates. Interleukin (IL)-8, IL-6, IL-1β and tumor necrosis factor α were measured in frontoparietal cortex homogenates.

Results: There was no difference in time to ROSC or inflammation and oxidative stress in the 3 oxygen groups.

Conclusions: Resuscitation with 18% oxygen did not result in differences in inflammation and oxidative stress when compared to 21 or 100% oxygen.

Keywords: Animal model; Birth asphyxia; Inflammation; Newborn piglet; Newborn resuscitation; Oxidative stress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Animals, Newborn
  • Asphyxia
  • Cardiopulmonary Resuscitation*
  • Disease Models, Animal
  • Heart Arrest / physiopathology*
  • Heart Massage
  • Hemodynamics
  • Hypoxia / physiopathology
  • Oxidative Stress*
  • Oxygen / administration & dosage*
  • Positive-Pressure Respiration / methods*
  • Random Allocation
  • Swine

Substances

  • Oxygen