Evaluation of standard and active compression-decompression CPR in an acute human model of ventricular fibrillation

Shultz, Jeffrey J.; Coffeen, Paul; Sweeney, Michael B.; Detloff, Barry L.S.; Kehler, C. H.; Pineda, Edgar; Yakshe, Paul N.; Adler, Steve; Chang, Mary P.; Lurie, Keith G.

doi:10.1016/0300-9572(94)90094-9

Cited by 6 publications

(9 citation statements)

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“…Results from this first demonstration of the use of an impedance valve during CPR in humans in cardiac arrest are similar to those we have previously observed in animal studies, 8,9 whereas the hemodynamic values found in the ACD CPR alone group are comparable with other human studies. 16 In addition to improving hemodynamics, 4 of 11 patients had a ROSC with the use of ACD CPR plus the impedance valve after a significantly shorter period of total CPR time (19.8Ϯ2.8 minutes), compared with 2 of 10 patients with ACD alone after a longer total CPR time (26.5Ϯ0.7 minutes). ETCO 2 has previously been used as a surrogate for cardiac output and blood flow through the lungs, although it is affected both by blood flow and by minute ventilation.…”

Section: Discussionmentioning

confidence: 97%

Inspiratory Impedance During Active Compression-Decompression Cardiopulmonary Resuscitation

2000

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This prospective, randomized, blinded trial was performed in prehospital mobile intensive care units in Paris, France. Patients in nontraumatic cardiac arrest received ACD CPR plus the ITV or ACD CPR alone for 30 minutes during advanced cardiac life support. End tidal CO(2) (ETCO(2)), diastolic blood pressure (DAP) and coronary perfusion pressure, and time to return of spontaneous circulation (ROSC) were measured. Groups were similar with respect to age, gender, and initial rhythm. Mean maximal ETCO(2), coronary perfusion pressure, and DAP values, respectively (in mm Hg), were 13.1+/-0.9, 25.0+/-1.4, and 36.5+/-1.5 with ACD CPR alone versus 19.1+/-1.0, 43.3+/-1.6, and 56.4+/-1.7 with ACD plus valve (P<0.001 between groups). ROSC was observed in 2 of 10 patients with ACD CPR alone after 26.5+/-0.7 minutes versus 4 of 11 patients with ACD CPR plus ITV after 19.8+/-2.8 minutes (P<0.05 for time from intubation to ROSC). Conclusions-Use of an inspiratory resistance valve in patients in cardiac arrest receiving ACD CPR increases the efficiency of CPR, leading to diastolic arterial pressures of >50 mm Hg. The long-term benefits of this new CPR technology are under investigation.

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Section: Discussionmentioning

confidence: 97%

Inspiratory Impedance During Active Compression-Decompression Cardiopulmonary Resuscitation

2000

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“…The theory of the active compression‐decompression device is that venous return to the heart can be increased during decompression by expanding the chest cavity and decreasing intrathoracic pressure. The results of studies utilizing these devices have been inconsistent 69,70,74 . Such a device may be difficult to use in most veterinary patients because of the hair coat.…”

Section: Basic Life Supportmentioning

confidence: 99%

Cardiopulmonary Resuscitation in Small Animal Medicine: An Update

Plunkett¹,

McMichael

2008

Veterinary Internal Medicne

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In December 2005, the American Heart Association published new guidelines for cardiopulmonary cerebral resuscitation (CPCR) in humans for the 1st time in 5 years. Many of the recommendations are based on research conducted in animal species and may be applicable to small animal veterinary patients. One important change that may impact how CPCR is performed in veterinary medicine is the recommendation to avoid administration of excessive ventilatory rates because this maneuver severely decreases myocardial and cerebral perfusion, decreasing the chance of survival. The new guidelines also emphasize the importance of providing well-executed, continuous, uninterrupted chest compressions. Interruption of chest compressions should be avoided and, if necessary, should be minimized to o10 seconds. During defibrillation, immediate resumption of chest compressions for 2 minutes after a single shock, before reassessment of the rhythm by ECG, is recommended. This recommendation replaces previous recommendations for the delivery of 3 defibrillatory shocks in rapid succession. Allowing permissive hypothermia postresuscitation has been found to be beneficial and may increase success rate. Medications utilized in cardiopulmonary resuscitation, including amiodarone, atropine, epinephrine, lidocaine, and vasopressin, along with the indications, effects, routes of administration, and dosages, are discussed. The application of the new guidelines to veterinary medicine as well as a review of cardiopulmonary resuscitation in small animals is provided.

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“…Active compression-decompression CPR increases cardiac output compared with standard CPR in various animal models, 100,101 maintains coronary perfusion during compression and decompression CPR in humans, 102 and provides ventilation if the airway is open. 102 Clinical trials report variable results with some benefit on short-term outcome measures (eg, return of spontaneous circulation and survival for 24 hours) [103][104][105] but no long-term survival benefits in most trials. On the basis of these variable clinical results, active compression-decompression CPR is considered an optional technique in adults (Class IIb; LOE 2,5,7).…”

Section: Mechanical Devices For Chest Compressionmentioning

confidence: 99%

Part 10: Pediatric Advanced Life Support

2000

Circulation

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Evaluation of standard and active compression-decompression CPR in an acute human model of ventricular fibrillation

Cited by 6 publications

References 0 publications

Inspiratory Impedance During Active Compression-Decompression Cardiopulmonary Resuscitation

Inspiratory Impedance During Active Compression-Decompression Cardiopulmonary Resuscitation

Cardiopulmonary Resuscitation in Small Animal Medicine: An Update

Part 10: Pediatric Advanced Life Support

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