Document Detail


Discriminating the effect of accelerated compression from accelerated decompression during high-impulse CPR in a porcine model of cardiac arrest.
MedLine Citation:
PMID:  20122780     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM OF THE STUDY: Piston based mechanical chest compression devices deliver compressions and decompressions in an accelerated pattern, resulting in superior haemodynamics compared to manual compression in animal studies. The present animal study compares haemodynamics during two different hybrid compression patterns to a standard compression pattern resembling that of modern mechanical chest compression devices. METHOD: In 12 anaesthetized domestic pigs in ventricular fibrillation, coronary perfusion pressures (CPP) and cerebral cortical blood flow (CCBF) was measured, and transesophageal echocardiography (TEE) was performed. Two hybrid compression patterns, one with accelerated trapezoid compression and slower sinusoid decompression (TrS), and one with slower sinusoid compression and accelerated trapezoid decompression (STr), were tested against a standard accelerated trapezoid compression-decompression pattern (TrTr) in a cross-over randomised setup. RESULTS: There were 7% (1, 14, p=0.046) lower CCBF and 3 mmHg (1, 5, p=0.017) lower CPP with the TrS compared to TrTr pattern. No significant difference between STr and TrTr pattern in either CCBF, 6% (-3, 15, p=0.176) or CPP, 0 mmHg (-2, 3, p=0.703) was present. Our TEE recordings were insufficient for haemodynamic comparison between the different compression-decompression patterns. Despite standardized sternal piston position and placement of the pigs, TEE revealed varying degree of asymmetrical heart chamber compression in the animals. CONCLUSION: Both cardiac and cerebral perfusion benefited from accelerated decompression, while accelerated compression did not improve haemodynamics. The evolution of mechanical CPR is dependent on further research on mechanisms generating forward blood flow during external chest compressions.
Authors:
?ystein T?mte; Ivar Sjaastad; Lars Wik; Artem Kuzovlev; Morten Eriksen; Per Andreas Norseng; Kjetil Sunde
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-01
Journal Detail:
Title:  Resuscitation     Volume:  81     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-15     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  488-92     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Institute for Experimental Medical Research and Centre for Heart Failure Research, Oslo University Hospital - Ullev?l, Oslo, Norway. oystetom@medisin.uio.no
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiopulmonary Resuscitation / instrumentation,  methods*
Cerebrovascular Circulation / physiology*
Coronary Circulation / physiology*
Echocardiography, Transesophageal
Female
Heart Arrest / therapy*
Swine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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