Complications of CPR

Nagel, Eugene L.; Fine, Ellen; Krischer, Jeffrey P.; Davis, Joseph H.

doi:10.1097/00003246-198105000-00037

Cited by 114 publications

(24 citation statements)

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“…Only one isolated case report of traumatic pancreatitis in a child 45 describes local trauma from abdominal compression during CPR. These data compare favorably with the well-known and frequent incidence of rib fracture and pulmonary contusion from chest compression during CPR [55][56][57] . Increased emesis and aspiration from IAC have not been reported, and there is evidence that if positive abdominal pressure is applied during ventilations from the beginning of an arrest, the rate of gastric inflation before endotracheal intubation is reduced 31 .…”

Section: Complications Of Iac-cprsupporting

confidence: 66%

Interposed abdominal compression CPR: a comprehensive evidence based review

Babbs

2003

Resuscitation

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Interposed abdominal compression (IAC)-CPR includes all steps of standard external CPR with the addition of manual mid-abdominal compressions in counterpoint to the rhythm of chest compressions. IAC-CPR can increase blood flow during CPR about two fold compared to standard CPR without IAC, as shown by 6 of 6 studies in computer models and 19 of 20 studies in various animal models. The addition of IAC has clinical benefit in humans, as indicated in 10 of 12 small to medium sized clinical studies. The technique increases the frequency of immediate return of spontaneous circulation for in-hospital resuscitations from roughly 25% to 50%. Improved survival to discharge is also likely on the basis of two small in-hospital trials. Possible harm from abdominal compression is minimal on the basis of 426 humans, 151, dogs and 14 pigs that received IAC in published reports. The complexity of performing IAC is similar to that of opening the airway and is less than that of other basic life support maneuvers. The aggregate evidence suggests that IAC-CPR is a safe and effective means to increase organ perfusion and survival, when performed by professionally trained responders in a hospital and when initiated early in the resuscitation protocol. Cost and logistical considerations discourage use of IAC-CPR outside of hospitals.

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Section: Complications Of Iac-cprsupporting

confidence: 66%

Interposed abdominal compression CPR: a comprehensive evidence based review

Babbs

2003

Resuscitation

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“…Only one isolated case report of traumatic pancreatitis in a child 64 describes local trauma from abdominal compression during CPR. These data compare favorably with the well-known and frequent incidence of rib fracture and pulmonary contusion from chest compression during CPR [65][66][67] . Increased emesis and aspiration from IAC have not been reported, and there is even evidence that if positive abdominal pressure is applied during ventilations from the beginning of an arrest, the rate of gastric inflation before endotracheal intubation is reduced 68 .…”

Section: Combining Chest and Abdominal Pumpssupporting

confidence: 66%

Circulatory adjuncts: Newer methods of cardiopulmonary resuscitation

Babbs

2002

Cardiology Clinics

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“…In our animals an endotracheal tube was securely in place, and gastric insufflation did not occur. Gastric insufflation is a common sequela of mouth-to-mouth ventilation in man [16], and abdominal pressure may induce vomiting after the stomach is distended with air [17]. However, if the IAC technique were used consistently from the beginning of resuscitation, gastric insufflation might be prevented entirely by the abdominal counterpressure.…”

Section: Discussionmentioning

confidence: 99%

Improved oxygen delivery during cardiopulmonary resuscitation with interposed abdominal compressions

Voorhees

Niebauer

Babbs

1983

Annals of Emergency Medicine

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The ability of a new modification of cardiopulmonary resuscitation (CPR) to deliver oxygen to tissues was evaluated. The method utilizes standard CPR techniques with the addition of manual abdominal compressions (100 mm Hg) interposed between chest compressions, and is termed interposed abdominal compression-CPR (IAC-CPR). Oxygen delivery was measured by a spirometer in a closed circuit designed to permit positive-pressure ventilation synchronized with mechanical chest compression. Ventricular fibrillation was induced electrically in 10 anesthetized dogs. In each dog, trials of IAC-CPR and standard CPR were alternated every five minutes during a 30-minute period. Arterial and central venous blood pressures, oxygen consumption, and Fick cardiac output were monitored. The addition of interposed abdominal compression significantly (P < 0.01) increased each of these hemodynamic indicators. Oxygen delivery increased from 4.12  0.39 ml O 2 /kg/min during standard CPR to 6.37  0.35 ml O 2 /kg/min during IAC-CPR. Arterial systolic blood pressure increased from 67  5 mm Hg to 90  5 mm Hg, while diastolic arterial blood pressure rose from 15  2 mm Hg to 33  3 mm Hg. Cardiac output increased from 19.9  2.6 ml/min/kg to 37.5  2.7 ml/min/kg.

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Complications of CPR

Cited by 114 publications

References 0 publications

Interposed abdominal compression CPR: a comprehensive evidence based review

Interposed abdominal compression CPR: a comprehensive evidence based review

Circulatory adjuncts: Newer methods of cardiopulmonary resuscitation

Improved oxygen delivery during cardiopulmonary resuscitation with interposed abdominal compressions

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