Comparison of electrocardiogram parameters in chest compression only resuscitation and interposed abdominal compression resuscitation in dogs with experimentally induced hemorrhagic shock

Document Type : Research Paper

Authors

1 DVSc Graduated of Small Animal Internal Medicine, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran

2 Professor, Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran

3 Associate Professor, Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran

Abstract

    Intermittent chest compression is still routinely used in resuscitation for hemorrhagic shock patients. There is a possibility that by using a different resuscitation method with interposed abdominal compressions, through forcing the blood from abdominal organs into the circulation and increasing intraperitoneal pressure, more blood pumps to heart. Therefore, in this study, chest compression resuscitation and interposed abdominal compressions resuscitation were compared in dogs with induced experimental hemorrhagic shock and electrocardiographic changes evaluated as an important diagnostic and monitoring tool in heart conduction and rhythm disorders. Thus hemorrhagic shock was induced by drawing blood from femoral artery in 15 dogs under anesthesia and continued until pulseless electrical activity achieved. The dogs were kept pulseless for 20 minutes, then were randomized to three treatment groups - fluid resuscitation alone with Ringer's lactate solution, chest compressions with fluid resuscitation, and interposed abdominal compression with fluid resuscitation. Resuscitation was conducted until reaching the point of return of spontaneous circulation. Electrocardiograms were recorded before the induction of hemorrhage, at the time that the pulse was lost, after 20 minutes of pulseless state and at the point of return of spontaneous circulation. Changes in P and QRS waves amplitudes, QT interval, heart rate, and electrical axis and morphology of ST segment was significant in different times within groups. but there were no significant changes in P and QRS durations and PR interval and heart rhythm. There were no significant changes in any parameter with different type of resuscitation method. Finally mixed effect of time and groups were also statistically insignificant in all parameters. In conclusion, it seems that there is no positive impact in electrocardiographic parameters using either of chest compression only or interposed abdominal compression resuscitation methods in dogs with induced hemorrhagic shock.

Keywords

References

Aliverti, A., Bovio, D., Fullin, I., Dellacà, R. L., Mauro, A. L., Pedotti, A., & Macklem, P. T. (2009). The abdominal circulatory pump. PLoS One, 4(5), e5550.
Azargoun, R., Avizeh, R., Ghadiri, A., Imani Rastabi, H., Pourmahdi Broujeni, M., & Razijalali, M. (2019). Comparison of tissue perfusion and electrocardiogram parameters in experimentally induced hemorrhagic shock dogs resuscitated with lactated ringer and hydroxyethyl starch solutions. Iranian Veterinary Journal, 15(2): 5-15. (In Persian)
Boller, M., Fletcher, D. J., Brainard, B. M., Haskins, S., Hopper, K., Nadkarni, V. M.,  Morley, P. T., McMichael, M., Nishimura, R., Robben, J. H., & Rozanski, E. (2016). Utstein-style guidelines on uniform reporting of in-hospital cardiopulmonary resuscitation in dogs and cats. A RECOVER statement. Journal of Veterinary Emergency and Critical Care, 26(1), 11-34.
Brody, D. A. (1956). A theoretical analysis of intracavitary blood mass influence on the heart-lead relationship. Circulation Research, 4(6), 731-738.
Buckhold, D. W., Pryor, W. H., Homer, L. D., Uddin, D. E., Hickey, T. M., & DiSimone, A. G. (1978). Hemorrhagic shock treatment with hot intravenous fluid in dogs. The Journal of Trauma, 18(10), 726-729.
Chandra, S., Singh, V., Nehra, M., Agarwal, D., & Singh, N. (2011). ST-segment elevation in non-atherosclerotic coronaries: a brief overview. Internal and Emergency Medicine, 6(2), 129-139.
Coleman, B., Kallal, J. E., Feigen, L. P., & Glaviano, V. V. (1975). Myocardial performance during hemorrhagic shock in the pancreatectomized dog. American Journal of Physiology-Legacy Content, 228(5), 1462-1468.
Davis, H., Jensen, T., Johnson, A., Knowles, P., Meyer, R.; Rucinsky, R., & Shafford, H. (2013). 2013 AAHA/AAFP fluid therapy guidelines for dogs and cats. Journal of the American Animal Hospital Association, 49(3): 149-159.
Dyson, D. H., & Sinclair, M. D. (2006). Impact of dopamine or dobutamine infusions on cardiovascular variables after rapid blood loss and volume replacement during isoflurane-induced anesthesia in dogs. American Journal of Veterinary Research, 67(7), 1121-1130.
Evans, C., Quinlan, D. O., Engels, P. T., & Sherbino, J. (2018). Reanimating patients after traumatic cardiac arrest: a practical approach informed by best evidence. Emergency Medicine Clinics, 36(1), 19-40.
Fletcher, D. J., Boller, M., Brainard, B. M., Haskins, S. C., Hopper, K., McMichael, M. A., Rozanski, E. A., Rush, J. E., & Smarick, S. D. (2012). RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 7: Clinical guidelines. Journal of Veterinary Emergency and Critical Care, 22(s1), S102-S131.
Georgiou, M., Papathanassoglou, E., Middleton, N., Papalois, A., & Xanthos, T. (2016). Combination of chest compressions and interposed abdominal compressions in a swine model of ventricular fibrillation. The American Journal of Emergency Medicine, 34(6), 968-974.
Giraud, R., Siegenthaler, N., Morel, D. R., & Bendjelid, K. (2012). The Brody effect to detect hypovolemia in clinical practice. Critical Care, 16(S1), P232.
Haskins, S. C. (2012). Shock. In: D. K, Macintire, K. J, Drobatz, S. C, Haskins, & W. D, Saxon. Manual of Small Animal Emergency and Critical Care Medicine (2nd ed. pp: 30-40). West Sussex: John Wiley & Sons.
Jeffcoach, D. R., Gallegos, J. J., Jesty, S. A., Coan, P. N., Chen, J., Heidel, R. E., & Daley, B. J. (2016). Use of CPR in hemorrhagic shock, a dog model. Journal of Trauma and Acute Care Surgery, 81(1), 27-33.
Kline, J. A., Thornton, L. R., Lopaschuk, G. D., Barbee, W. R., & Watts, J. A. (1999). Heart function after severe hemorrhagic shock. Shock, 12(6), 454-461.
Laforcade, A. D., & Silverstein, D. C. (2015) Shock. In: D. C, Silverstein, & K, Hopper. Small Animal Critical Care Medicine (2nd ed. pp: 26-30). Missouri: Elsevier.
Li, M., Song, W., Ouyang, Y. H., Wu, D. H., Zhang, J., Wang, L. X., & Li, J. (2017). Clinical evaluation of active abdominal lifting and compression CPR in patients with cardiac arrest. The American Journal of Emergency Medicine, 35(12), 1892-1894.
Li, J. K., Wang, J., & Li, T. F. (2014). Interposed abdominal compression-cardiopulmonary resuscitation after cardiac surgery. Interactive Cardiovascular and Thoracic Surgery, 19(6), 985-989.
MacDonald, J. A., Milligan, G. F., Mellon, A., & Ledingham, I. M. (1975). Ventricular function in experimental hemorrhagic shock. Surgery, Gynecology & Obstetrics, 140(4), 572-581.
Martin, M. (2015). Small Animal ECGs: An Introductory Guide (3rd Edittion). John Wiley & Sons. West Sussex, Pp: 1-14.
Mauro, K. D., & Drobatz, K. J. (2020). Global Approach to the Trauma Patient. In: K. J, Drobatz, K, Hopper, E. A, Rozanski, & Silverstein, D. C. Textbook of Small Animal Emergency Medicine. (pp: 39-43) West Sussex: John Wiley & Sons.
McIntyre, R. L., Hopper, K., & Epstein, S. E. (2014). Assessment of cardiopulmonary resuscitation in 121 dogs and 30 cats at a university teaching hospital (2009–2012). Journal of Veterinary Emergency and Critical Care, 24(6), 693-704.
Movahedi, A., Mirhafez, S. R., Behnam‐Voshani, H., Reihani, H., Kavosi, A., Ferns, G. A., & Malekzadeh, J. (2016). A Comparison of the Effect of Interposed Abdominal Compression Cardiopulmonary Resuscitation and Standard Cardiopulmonary Resuscitation Methods on End‐tidal CO 2 and the Return of Spontaneous Circulation Following Cardiac Arrest: A Clinical Trial. Academic Emergency Medicine, 23(4), 448-454.
Oyama, M. A., Kraus, M. S., & Gelzer, A. R. (2019). Rapid Review of ECG Interpretation in Small Animal Practice (pp: 17-26). Florida: CRC Press.
Roos, J. C., & Dunning, A. J. (1970). Right bundle-branch block and left axis deviation in acute myocardial infarction. Heart, 32(6): 847-851.
Rosborough, J. P.; Niemann, J. T.; Criley, J. M.; Ob́annon, W., & Rouse, D. (1981). Lower abdominal compression with synchronized ventilation - a CPR modality. Circulation, 64(4): 303-309.
Rottenberg, E. M. (2016). The need for abdominal only CPR in the treatment of hemorrhagic shock and trauma arrests. The American Journal of Emergency Medicine, 34(6), 1156-1157.
Santilli, R., Moïse, N. S., Pariaut, R., & Perego, M. (2019). Electrocardiography of the Dog and Cat (2nd ed. pp: 52-89) Milan: Edra.
Shaylor, R., Gavish, L., Yaniv, G., Wagnert-Avraham, L., Gertz, S. D., Weissman, C., Megreli, J., Shimon, G., Simon, B., Berman, A., & Eisenkraft, A. (2020). Early maladaptive cardiovascular responses are associated with mortality in a porcine model of hemorrhagic shock. Shock, 53(4), 485-492.
Skjeflo, G. W., Skogvoll, E., Loennechen, J. P., Olasveengen, T. M., Wik, L., & Nordseth, T. (2019). The effect of intravenous adrenaline on electrocardiographic changes during resuscitation in patients with initial pulseless electrical activity in out of hospital cardiac arrest. Resuscitation, 136, 119-125.
Tilley, L. P., & Smith, Jr., F. W. K. (2016) Electrocardiography. In: Jr., F. W. K. Smith, L. P., Tilley, L. P., Oyama, M. A., & Sleeper, M. M. Manual of Canine and Feline Cardiology (5th ed., pp: 49-76). Missouri: Elsevier.
Willis, R. (2018) Electrocardiography. In: R., Willis, P., Oliveira, & A., Mavropoulou. Guide to Canine and Feline Electrocardiography (pp:35-56). New Jersey:John Wiley & Sons.

Files

Share

How to cite

Statistics