Chest compression during sustained inflation: hypoxic and oxidative stress

Current recommendation for chest compressions in neonatal resuscitation is to use a coordinated 3:1 ratio of chest compressions to ventilations (C:V), interrupting every third compression to deliver an assisted ventilation. Despite this recommendation, the evidence is still unclear on the optimal C:V ratio for use in neonates. Our team has previously reported a novel technique of sustained inflations with chest compressions (SI+CC) reduces time to return of spontaneous circulation and improves hemodynamic recovery. The objective of this study was to determine differences in hypoxic injury and oxidative stress markers of heart and lung in piglets resuscitated with SI+CC compared to a coordinated 3:1 C:V. We found that the SI+CC technique reduces oxidative stress in lung tissues and cumulative oxygen exposure with no differences in hypoxic injury. Our findings lend further support to transitioning this technique to neonatal resuscitation practice.