Comparison of Blood Flow During External and Internal Cardiac Massage in Man

Guercio, Louis R. M. Del; Feins, Neil R.; Cohn, Joseph D.; Coomaraswamy, R.; Wollman, Stuart B.; D, State; Orkin, Louis R.

doi:10.1097/00132586-196604000-00031

Cited by 26 publications

(29 citation statements)

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“…With the chest closed, however, the pressure is applied both to the cardiac ventricles and to other mediastinal structures including the atria, the esophagus, and some of the great vessels. In this sense, even idealized closed chest cardiac massage is less selective than open chest ventricular massage and in particular causes high venous pressure spikes during the compression phase [4][5][6][7], which are absent during open chest CPR [6,7]. Considerable evidence published over the last five years suggests that pressure pulses developed during chest massage are even more widely distributed throughout the thorax.…”

Section: Introductionmentioning

confidence: 99%

Cardiac, thoracic, and abdominal pump mechanisms in cardiopulmonary resuscitation: Studies in an electrical model of the circulation

Babbs¹,

Weaver²,

Ralston³

et al. 1984

The American Journal of Emergency Medicine

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To investigate alternative mechanisms generating artificial circulation during cardiopulmonary resuscitation (CPR), an electrical model of the circulation was developed. Heart and blood vessels were modeled as resistive-capacitive networks; pressures in the chest, abdomen, and vascular compartments as voltages; blood flow as electric current; blood inertia as inductance; and the cardiac and venous valves as diodes. External pressurization of thoracic and abdominal vessels, as would occur in CPR, was simulated by application of half-sinusoidal voltage pulses. Three modes of creating artificial circulation were studied: cardiac pump (CP), in which the atria and ventricles of the model were pressurized simultaneously; thoracic pump (TP), in which all intrathoracic elements of the model were pressurized simultaneously; and abdominal pump (AP), in which the abdominal aorta and inferior vena cava of the model were pressurized simultaneously. Flow was greatest with the CP, less with the TP, and least with the AP mechanism. However, the AP could be practically combined with either the CP or TP by interposition of abdominal compressions between chest compressions (IAC-CPR). Our model predicts that this combined method can substantially improve artificial circulation, especially when cardiac compression does not occur and chest compression invokes only the thoracic pump mechanism.

show abstract

Section: Introductionmentioning

confidence: 99%

Cardiac, thoracic, and abdominal pump mechanisms in cardiopulmonary resuscitation: Studies in an electrical model of the circulation

Babbs¹,

Weaver²,

Ralston³

et al. 1984

The American Journal of Emergency Medicine

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show abstract

“…Standard CPR utilizes only one of these modes-chest compression-and generates roughly 1 L/min forward flow in an adult human 45 , which is 20 percent of normal cardiac output. Interposed abdominal compression CPR utilizes two of these modes-chest compression and abdominal compression-and generates roughly twice the forward flow, or 2 L/min in an adult human 61 .…”

Section: Discussionmentioning

confidence: 99%

“…This state of affairs represents idealized classical external CPR in which "the heart is squeezed between the sternum and the spine" as reported in 1965 by DelGuercio 45 . It is also a reasonable representation of open chest CPR with manual cardiac compression, which obviously works by a pure "cardiac pump" mechanism.…”

Section: Modern Physiology Of Blood Flow During Cprmentioning

confidence: 98%

Circulatory adjuncts: Newer methods of cardiopulmonary resuscitation

Babbs

2002

Cardiology Clinics

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“…In the small number of patients studied, direct cardiac massage more than doubled the closed chest cardiac output (Del Guercio et al, 1965), while mean circulation time fell significantly.…”

mentioning

confidence: 87%

Open-chest cardiac massage for non-traumatic cardiac arrest.

Robertson

1987

Emergency Medicine Journal

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Comparison of Blood Flow During External and Internal Cardiac Massage in Man

Cited by 26 publications

References 0 publications

Cardiac, thoracic, and abdominal pump mechanisms in cardiopulmonary resuscitation: Studies in an electrical model of the circulation

Cardiac, thoracic, and abdominal pump mechanisms in cardiopulmonary resuscitation: Studies in an electrical model of the circulation

Circulatory adjuncts: Newer methods of cardiopulmonary resuscitation

Open-chest cardiac massage for non-traumatic cardiac arrest.

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