Background-Guidelines on neonatal resuscitation recommend 90 chest compressions (CCs) and 30 manual inflations (3:1) per minute in newborns. The study aimed to determine whether CC s during sustained inflations (SIs) improves the recovery of asphyxiated newborn piglets in comparison with coordinated 3:1 resuscitation. Methods and Results-Term newborn piglets (n=8/group) were anesthetized, intubated, instrumented, and exposed to 45-minute normocapnic hypoxia followed by asphyxia. Piglets were randomly assigned to receive either 3:1 resuscitation (3:1 group) or CCs during SIs (SI group) when the heart rate decreased to 25% of baseline.

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Background: 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). Objective: 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. Intervention and Measurements: 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, n = 8), a 3:1 C:V using 90 CC and 30 inflations (3:1, n = 8), or a sham group (n = 6). Cardiac function, carotid blood flow, cerebral oxygenation, and respiratory parameters were continuously recorded throughout the experiment. Results: 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 (p = 0.048). CC+SI also significantly reduced the requirement for 100% oxygen, improved respiratory parameters, and resulted in a similar hemodynamic recovery. Conclusions: 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.

ObjectiveRecently, sustained inflations (SI) during chest compression (CC) have been suggested as an alternative to the current approach during neonatal resuscitation. However, the optimal rate of CC during SI has not yet been established. Our aim was to determine whether different CC rates during SI reduce time to return of spontaneous circulation (ROSC) and improve hemodynamic recovery in newborn piglets with asphyxia-induced bradycardia.Intervention and measurementsTerm newborn piglets were anesthetized, intubated, instrumented and exposed to 45-min normocapnic hypoxia followed by asphyxia. Resuscitation was initiated when heart rate decreased to 25% of baseline. Piglets were randomized into three groups: CC superimposed by SI at a rate of 90 CC per minute (SI+CC 90, n = 8), CC superimposed by SI at a rate of 120 CC per minute (SI+CC 120, n = 8), or a sham group (n = 6). Cardiac function, carotid blood flow, cerebral oxygenation and respiratory parameters were continuously recorded throughout the experiment.Main resultsBoth treatment groups had similar time of ROSC, survival rates, hemodynamic and respiratory parameters during cardiopulmonary resuscitation. The hemodynamic recovery in the subsequent 4h was similar in both groups and was only slightly lower than sham-operated piglets at the end of experiment.ConclusionNewborn piglets resuscitated by SI+CC 120 did not show a significant advantage in ROSC, survival, and hemodynamic recovery as compared to those piglets resuscitated by SI+CC 90.

Background: High-quality chest compression is essential during neonatal cardiopulmonary resuscitation (CPR). However, the optimal compression to ventilation ratio (C:V) that should be used during neonatal CPR to optimize coronary and cerebral perfusion while providing adequate ventilation remains unknown. Objective: We hypothesized that different C:V ratios (e.g., 2: 1 or 4: 1) will reduce the time to return of spontaneous circulation (ROSC) in severely asphyxiated piglets. Methods: Thirty-one newborn piglets (1–4 days old) were anesthetized, intubated, instrumented, and exposed to 50-min normocapnic hypoxia followed by asphyxia. Piglets were randomized into 4 groups: 2: 1 (n = 8), 3: 1 (n = 8), 4: 1 (n = 8) C:V ratio, or a sham group (n = 7). Cardiac function, carotid blood flow, cerebral oxygenation, and respiratory parameters were continuously recorded throughout the experiment. Results: Thirty-one piglets were included in the study, and there was no difference in the duration of asphyxia or the degree of asphyxiation (as indicated by pH, PaCO₂, and lactate) among the different groups. The median (IQR) time to ROSC was similar between the groups with 127 (82–210), 96 (88–126), and 119 (83–256) s in the 2: 1, 3: 1, and 4: 1 C:V ratio groups, respectively (p = 0.67 between groups). Similarly, there was no difference in 100% oxygen requirement or epinephrine administration between the experimental groups. Conclusions: Different C:V ratios resulted in similar ROSC, mortality, oxygen, and epinephrine administration during resuscitation in a porcine model of neonatal asphyxia.

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In view of the facts that ginseng has been shown to improve age-related memory deficits and beta-amyloid-related peptides have been suggested to play a significant role in memory degeneration in the elderly, the present study was carried out to examine the effect of various ginsenosides on beta-amyloid peptides-modulated acetylcholine (ACh) release, a key neurotransmitter in memory processing, from the hippocampal slices. Addition of beta-amyloid fragment(25 - 35) (0.01 - 1 microM) in the superfusion medium suppressed the K(+)-evoked [(3)H]-ACh release from the rat hippocampal slices in a concentration-related manner and about 40 % reduction in ACh outflow was observed when incubating with the highest concentration of an amyloid fragment (1 microM). Inclusion of the ginsenoside components Rb(1) (0.1 microM), but not Rg(1), caused a rightward shift of the concentration-response curve of beta-amyloid. The reversal of the beta-amyloid-inhibited ACh release by Rb(1) was not blocked by tetrodotoxin (1 microM) indicating that an interaction occurs at the cholinergic synapse. These results suggest that Rb(1) may elicit its anti-amnesic effect by minimizing the inhibitory effect of beta-amyloid peptides.