Echocardiographic comparison of cardiopulmonary resuscitation (CPR) using periodic acceleration (pGz) versus chest compression

Nava, Guillermo; Adams, José A.; Bassuk, Jorge; Wu, Dongmei; Kurlansky, Paul; Lamas, Gervasio A.

doi:10.1016/j.resuscitation.2004.11.029

Cited by 19 publications

(6 citation statements)

References 28 publications

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“…Most of the devices are designed to be light and compact for out-of-hospital CPR, while the EM-CPR, [13][14][15] the parallel manipulator, 16 and the pGz [17][18][19][20] are intended for in-hospital CPR only ( Table 2). All the devices, but the CardioPump and the LUCAS, perform exclusively chest compression.…”

Section: Cpr Devicesmentioning

confidence: 99%

“…Therefore, they obviate many drawbacks of conventional CPR: no chest or abdominal injuries due to mechanical manipulation, suitability to be used on patients with chest operations, and no limitations based on the chest dimension. [17][18][19][20] Although a manual massage is prone to repeatability errors because the rescuer's performance decreases over time, an automated massage is affected by systematic errors when the device is wrongly positioned (point and direction of compression). Furthermore, an incorrect placement might not only impair the effectiveness of CPR but also increase the risk of injury.…”

Section: Advantages and Limits Of Cpr Devicesmentioning

confidence: 99%

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Automatic and manual devices for cardiopulmonary resuscitation: A review

Remino

Baronio

Pellegrini

et al. 2018

Advances in Mechanical Engineering

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Rate of survival without any neurological consequence after cardiac arrest is driven not only by early recognition but also by high-quality cardiopulmonary resuscitation. Because the effectiveness of the manual cardiopulmonary resuscitation is usually impaired by rescuers' fatigue, devices have been devised to improve it by appliances or ergonomic solutions. However, some devices are thought to replace the manual resuscitation altogether, either mimicking its action or generating hemodynamic effects with working principles which are entirely different. This article reviews such devices, both manual and automatic. They are mainly classified by actuation method, applied force, working space, and positioning time. Most of the trials and meta-analyses have not demonstrated that chest compressions given with automatic devices are more effective than those given manually. However, advances in clinical research and technology, with an improved understanding of the organizational implications of their use, are constantly improving the effectiveness of such devices.

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Section: Cpr Devicesmentioning

confidence: 99%

Section: Advantages and Limits Of Cpr Devicesmentioning

confidence: 99%

Automatic and manual devices for cardiopulmonary resuscitation: A review

Remino

Baronio

Pellegrini

et al. 2018

Advances in Mechanical Engineering

View full text Add to dashboard Cite

show abstract

“…Postresuscitation myocardial stunning has been investigated using echocardiographic variables of ventricular function. In contrast to chest compression, pGzresuscitated swine show fewer instances of myocardial stunning, as evidenced by comparatively better ejection fraction, fractional shortening, and wall motion; less arrhythmias postresuscitation; and overall better myocardial function (114). We also studied postresuscitation biochemical indices of myocardial damage and found a striking difference and attenuation in troponin I, tumor necrosis factor-␣, and IL-6 in pGz-resuscitated animals compared with chest compression (115).…”

Section: Pgz and Cprmentioning

confidence: 92%

Endothelium and cardiopulmonary resuscitation

Adams

2006

Critical Care Medicine

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The endothelium is a viable target for injury, repair and cellular modulation. Because of its vast extension and active metabolic status of producing mediators for vasomotor tone, coagulation, and inflammation, it is a key target for therapy during ischemia/reperfusion injury. Cardiopulmonary resuscitation is a model of whole-body ischemia/reperfusion injury. It has become apparent that the endothelium participates in a host of responses elicited by ischemia/reperfusion. This review examines the role of the endothelium during and after ischemia/reperfusion and the participation by its mediators and evidence for endothelial involvement during and after cardiopulmonary resuscitation. The strategic location of the endothelium makes it an excellent signal transduction mechanism for a host of disease processes. In addition to biochemical stimuli, mechanical stimulation of the endothelium elicits production of several mediators, including endothelium-derived nitric oxide, prostaglandins, and antithrombotics and anticoagulants. Whole-body, periodic acceleration is a novel method of stimulating the endothelium via pulsatile shear stress. Periodic acceleration has been shown to be an effective experimental method of cardiopulmonary resuscitation, with evidence of postresuscitation cardioprotective effects. This review indicates that understanding endothelial modulation during and after ischemia/reperfusion will significantly improve therapeutic choices.

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“…Echocardiography was performed with a HewlettPackard SONOS 2000 echocardiographic system with a 3.5/2.7 MHz transducer and recorded on VCR tapes. In each animal, two-dimensional short-axis view and M-mode tracings were performed according to the recommendation of the American Society of Echocardiography and as previously described by our laboratory (8,36,37). All measurements were performed by an investigator blinded to the treatment assignment.…”

Section: Methodsmentioning

confidence: 99%

Acute Effects of “Delayed Postconditioning” With Periodic Acceleration After Asphyxia Induced Shock in Pigs

et al. 2008

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Asphyxia cardiac arrest and shock are models for whole body ischemia reperfusion injury. Periodic acceleration (pGz) achieved by moving the body on a platform is a novel method for inducing pulsatile vascular shear stress and endogenous production of endothelial nitric oxide, prostaglandin E 2 , tissue plasminogen activator, and adrenomedullin. The aforementioned are cardioprotective during and after ischemia reperfusion injury. We investigated whether pGz, applied 15 min after return of spontaneous circulation (ROSC) would serve as an effective "delayed" post conditioning tactic to lessen acute reperfusion injury markers in a pediatric swine model of asphyxia induced shock. Asphyxia shock was induced in 20 swine weight 3.9 Ϯ 0.6 kg. Fifteen minutes after ROSC, the animals were randomized to receive conventional mechanical ventilation (CMV, [Control]) or CMV with pGz. All animals had ROSC and no significant differences in blood gases or hemodynamics after ROSC. pGz treated had significantly less myocardial dysfunction post resuscitation, (i.e. better % ejection fraction (EF), % fractional shortening (FS), and wall motion score index) and lower biochemical indices of reperfusion injury (lower TNF-␣, IL-6, and Troponin I, and myeloperoxidase activity). Delayed postconditioning with pGz ameliorates acute post resuscitation reperfusion injury and improves myocardial dysfunction after asphyxia-induced shock.

show abstract

Echocardiographic comparison of cardiopulmonary resuscitation (CPR) using periodic acceleration (pGz) versus chest compression

Cited by 19 publications

References 28 publications

Automatic and manual devices for cardiopulmonary resuscitation: A review

Automatic and manual devices for cardiopulmonary resuscitation: A review

Endothelium and cardiopulmonary resuscitation

Acute Effects of “Delayed Postconditioning” With Periodic Acceleration After Asphyxia Induced Shock in Pigs

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