Document Detail

Two-thumb versus two-finger chest compression during CRP in a swine infant model of cardiac arrest.
MedLine Citation:
PMID:  8427439     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: To test the hypothesis that two-thumb chest compression generates higher arterial and coronary perfusion pressures than the current American Heart Association-approved two-finger method. DESIGN: Randomized, crossover experimental trial. SETTING AND PARTICIPANTS: Animal laboratory experiment with seven swine of either sex weighing 9.4 kg (SD, 0.8 kg), representing infants less than 1 year old. INTERVENTIONS: Animals were sedated with IM ketamine/xylazine, intubated with a 6.0 Hi-Lo endotracheal tube, anesthetized with alpha-chloralose, and paralyzed with pancuronium. ECG was monitored continuously. Left femoral arterial and Swan-Ganz catheters were placed. Cardiac arrest was induced with an IV bolus of KCl and verified by ECG and pressure tracings. Five American Heart Association-certified basic rescuers were randomly assigned to perform external chest compressions for one minute by either the currently recommended two-finger method or the two-thumb and thorax-squeeze method. After all five completed their first trial, rescuers crossed over to the other method for a second minute of compressions. Ventilation was performed with a bag-valve device, and no drugs were given during CPR. After three complete cycles, the fourth through sixth cycles of compressions were recorded. Every compression was analyzed for arterial systolic, diastolic, mean, and coronary perfusion pressures. One thousand fifty compressions were analyzed with repeated-measures analysis of variance and Scheffé multiple comparisons. RESULTS: Systolic blood pressure, diastolic blood pressure, mean arterial pressure, and coronary perfusion pressure were all significantly higher (P < .001) with the two-thumb thoracic squeeze technique: systolic blood pressure, 59.4 versus 41.6 mm Hg; diastolic blood pressure, 21.8 versus 18.5 mm Hg; mean arterial pressure, 34.2 versus 26.1 mm Hg; and coronary perfusion pressure, 15.1 versus 12.2 mm Hg. CONCLUSION: The two-thumb method of chest compression generates significantly higher arterial and coronary perfusion pressures than the two-finger method in this infant model of cardiac arrest.
J J Menegazzi; T E Auble; K A Nicklas; G M Hosack; L Rack; J S Goode
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  22     ISSN:  0196-0644     ISO Abbreviation:  Ann Emerg Med     Publication Date:  1993 Feb 
Date Detail:
Created Date:  1993-03-04     Completed Date:  1993-03-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  240-3     Citation Subset:  AIM; IM    
Division of Emergency Medicine, University of Pittsburgh School of Medicine, Pennsylvania.
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MeSH Terms
Blood Pressure
Cardiopulmonary Resuscitation / methods*
Coronary Circulation
Heart Arrest / therapy*
Infant, Newborn* / physiology
Models, Cardiovascular
Random Allocation
Comment In:
Ann Emerg Med. 1993 Dec;22(12):1924-5   [PMID:  8305050 ]

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

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