Background: Mechanical chest compression (CC) is currently suggested to deliver sustained high‐quality CC in a moving ambulance. This study compared the hemodynamic support provided by a mechanical piston device or manual CC during ambulance transport in a porcine model of cardiopulmonary resuscitation. Methods and Results: In a simulated urban ambulance transport, 16 pigs in cardiac arrest were randomized to 18 minutes of mechanical CC with the LUCAS (n=8) or manual CC (n=8). ECG, arterial and right atrial pressure, together with end‐tidal CO ₂ and transthoracic impedance curve were continuously recorded. Arterial lactate was assessed during cardiopulmonary resuscitation and after resuscitation. During the initial 3 minutes of cardiopulmonary resuscitation, the ambulance was stationary, while then proceeded along a predefined itinerary. When the ambulance was stationary, CC‐generated hemodynamics were equivalent in the 2 groups. However, during ambulance transport, arterial and coronary perfusion pressure, and end‐tidal CO ₂ were significantly higher with mechanical CC compared with manual CC (coronary perfusion pressure: 43±4 versus 18±4 mmHg; end‐tidal CO ₂ : 31±2 versus 19±2 mmHg, P <0.01 at 18 minutes). During cardiopulmonary resuscitation, arterial lactate was lower with mechanical CC compared with manual CC (6.6±0.4 versus 8.2±0.5 mmol/L, P <0.01). During transport, mechanical CC showed greater constancy compared with the manual CC, as represented by a higher CC fraction and a lower transthoracic impedance curve variability ( P <0.01). All animals in the mechanical CC group and 6 (75%) in the manual one were successfully resuscitated. Conclusions: This model adds evidence in favor of the use of mechanical devices to provide ongoing high‐quality CC and tissue perfusion during ambulance transport.

Background: Ventilation with the noble gas argon (Ar) has shown neuroprotective and cardioprotective properties in different in vitro and in vivo models. Hence, the neuroprotective effects of Ar were investigated in a severe, preclinically relevant porcine model of cardiac arrest. Methods and Results: Cardiac arrest was ischemically induced in 36 pigs and left untreated for 12 minutes before starting cardiopulmonary resuscitation. Animals were randomized to 4‐hour post‐resuscitation ventilation with: 70% nitrogen–30% oxygen (control); 50% Ar–20% nitrogen–30% oxygen (Ar 50%); and 70% Ar–30% oxygen (Ar 70%). Hemodynamic parameters and myocardial function were monitored and serial blood samples taken. Pigs were observed up to 96 hours for survival and neurological recovery. Heart and brain were harvested for histopathology. Ten animals in each group were successfully resuscitated. Ninety‐six‐hour survival was 60%, 70%, and 90%, for the control, Ar 50%, and Ar 70% groups, respectively. In the Ar 50% and Ar 70% groups, 60% and 80%, respectively, achieved good neurological recovery, in contrast to only 30% in the control group ( P <0.0001). Histology showed less neuronal degeneration in the cortex ( P <0.05) but not in the hippocampus, and less reactive microglia activation in the hippocampus ( P =0.007), after Ar compared with control treatment. A lower increase in circulating biomarkers of brain injury, together with less kynurenine pathway activation ( P <0.05), were present in Ar‐treated animals compared with controls. Ar 70% pigs also had complete left ventricular function recovery and smaller infarct and cardiac troponin release ( P <0.01). Conclusions: Post‐resuscitation ventilation with Ar significantly improves neurologic recovery and ameliorates brain injury after cardiac arrest with long no‐flow duration. Benefits are greater after Ar 70% than Ar 50%.

This study estimates the accuracy of the focused lung ultrasound (FLUS) compared with systematic thoracic ultrasonography (TUS) as the reference test for diagnosing pneumonia in pre- and postweaned dairy calves. One hundred thirty-five Holstein Friesian calves, aged between 1 to 6 mo were enrolled and were kept in the same pen with one or more animals showing signs of bovine respiratory disease complex (BRDC). One operator performed FLUS on each calf, and then a second, blinded operator performed TUS on the same calf. For the FLUS, we only scanned the lung lobes that are most frequently affected during BRDC and are thus easier to detect, such as the caudal aspect of the cranial lobe of the left lung (fifth and fourth left intercostal spaces; ICS), the middle lobe of the right lung (fifth right ICS), and the caudal aspect of the cranial lobe of the right lung (fourth right ICS). Pneumonia was diagnosed when a calf had a minimum of one small lobular lung lesion that was at least 1 cm deep within a normally aerated lobe (TUS score of ≥2). Diagnostic accuracy indexes of the FLUS were calculated using TUS as the gold standard. The McNemar test was performed to evaluate the differences between the 2 techniques. In addition, an intertest agreement was assessed using the weighted kappa test. A total of 76 out of 135 calves had a TUS score of ≥2 and were therefore considered to be affected by BRDC. The FLUS had a sensitivity of 81.6% (95% CI = 71.0-89.5%), specificity = 100% (95% CI = 93.9-100%), positive predictive value was 100%, negative predictive value was 96.6% (95% CI = 94.7---97.9%), and accuracy was 97% (95% CI = 92.6-99.2%). The McNemar test highlighted a difference of 10.3% between the FLUS and TUS. The agreement between the TUS and FLUS was substantial (weighted kappa test 0.78). Although FLUS shows some limitations in diagnosing lung lesions associated with BRDC compared with the systematic approach, this study shows that the focused method could be used as an additional tool for evaluating consolidation, especially when examining a large number of postweaned dairy calves.

The objectives of this study were to investigate the main risk factors associated with calving ease (CE) in Italian Holstein cow herds, and to estimate the association between CE and subsequent survival, fertility and milk production. Data obtained from Holstein cows in 40 Italian herds were retrospectively investigated. Calvings were surveilled and classified into two categories of CE, unassisted calving or assisted calving, based on the need for intervention. The following factors were analyzed as possible risk factor affecting CE: herd, number of calvings/herd/year, age at first calving (AFC), cow parity, gestation length, twinning, calf sex, previous calving-to-conception interval, previous milk yield, dry period and close-up length, and season of calving. The association between CE and culling risk within the first 30 days-in-milk (DIM), cumulative 60-d milk yield and predicted 305-d milk yield, and pregnancy risk within 150 DIM were also investigated. Of the 47,672 calvings, 37,892 (79.5%) were unassisted, while 9780 (20.5%) required some type of assistance. Among the risk factors, only the AFC was not correlated with CE, while for all the other risk factors an association with CE was detected. Assisted calvings were associated with an increased culling risk at 30 DIM, decreased 60-d milk yield, decreased 305-d milk yield and reduced pregnancy risk at 150 DIM. In conclusion, dairy herd management should aim at correcting/reducing the risk factors in order to limit the incidence of assisted calving, and possibly improve the quality of calving assistance; controlling CE within the herd is crucial to reducing culling risk, and achieving higher lactation and reproductive performance.

Recently, the use of antimicrobials on dairy farms has been significantly limited from both the legislative and consumer points of view. This study aims to check the efficacy of selective dry cow therapy (SDCT) versus blanket dry cow therapy (BDCT) on bovine udder in healthy animals. SDTC is when an antibiotic is administered only to infected cows, compared with BDCT, where all cows receive an antimicrobial, regardless of their infection status. The milk samples were collected from enrolled Holstein Friesian cows 7 days before dry-off (T0) and 10 days after calving (T1) to assess somatic cell count (SCC), intramammary infections (IMIs), and milk microbiota variation. After pre-drying sampling, cows are randomly assigned to the following treatments: internal teat sealant alone (ITS; 24 cows), which is a treatment in a cow that does not receive antibiotics in SDTC, or in combination with intramammary antibiotic treatment (A+ITS; 22 cows). Non-statistically significant results are found between the two treatment groups at T1 for SCC, milk yield, and alpha diversity in milk microbiota. A statistically (p < 0.033) T1 IMI decrease is reported in the A+ITS group, and a significant beta diversity analysis is shown between the two timepoints (p = 0.009). This study confirms the possibility of selective drying without new IMI risk or increased SCC at calving, considering healthy cows without contagious infections and SCC values >200,000 cells/mL in the previous lactation.