Changes in Hemodynamic Parameters During 10 Min of Chest Compressions at Different Positions in Cadaveric Newborn Piglets

Background: Current neonatal cardiopulmonary resuscitation guidelines recommend delivering chest compressions (CC) using the two-thumb encircling technique with the healthcare provider positioned preferably over-the-head (OTH) of the bed, but other positions may also include the side or the bottom of the bed. Aim: To compare compression-generated mechanical hemodynamic signals between three rescuer positions (OTH, side, bottom) during 10 min of two-thumb CC in a cadaveric newborn piglet model. Methods: Following euthanization, piglets were randomly allocated to 10 min of CC performed from either the OTH, side, or bottom position using the two-thumb encircling technique. Compression-generated mechanical signals of blood flow and pressure were measured continuously during CC. Due to the absence of intrinsic myocardial contractility in this cadaveric model, the reported variables reflect compression-generated mechanical hemodynamic signals only. Results: Twenty-one newborn piglets (1–3 days of age, weighing 1.7–2.3 kg) were included in the study. There were no differences in compression-generated mechanical hemodynamics when CC were performed at the OTH, side, or bottom positions. Conclusions: In this cadaveric piglet model, no difference in compression-generated mechanical hemodynamics was observed between positions. However, in vivo validation in neonatal cardiac arrest models with variable rescuers as well as clinical studies is warranted to determine if any position translates into improved resuscitation outcomes.