Hemodynamic effects of closed and open chest cardiac resuscitation in normal dogs and those with acute myocardial infarction

Weiser, Frank M.; Adler, Lawrence N.; Kuhn, Leslie A.

doi:10.1016/0002-9149(62)90382-x

Cited by 100 publications

(23 citation statements)

References 20 publications

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“…Each data point represents the mean  SD of the 20-30 normalized cardiac output measurements obtained in the 10 dogs. The absolute value for cardiac output during standard CPR (42  19 ml/min/kg) for the 10 dogs in experiment 1, is within the range of values previously reported by others in dogs and in humans (4,9,14,15). As compression rate increased from zero to 140/min, cardiac output rose to a plateau.…”

Section: Manipulation Of Compression Rate and Duration: Experimentssupporting

confidence: 84%

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Cardiac output during cardiopulmonary resuscitation at various compression rates and durations

Fitzgerald¹,

Babbs²,

Frissora³

et al. 1981

American Journal of Physiology-Heart and Circulatory Physiology

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Davis, Robert W.; and Silver, Douglas I., "Cardiac output during cardiopulmonary resuscitation at various compression rates and durations" (1981) AbstractCardiac output during cardiopulmonary resuscitation (CPR) was measured by a modified indicator-dilution technique in 20 anesthetized dogs (6-12 kg) during repeated 1-to 2-min episodes of electrically induced ventricular fibrillation and CPR, produced by a mechanical chest compressor and ventilator. With compression rates from 20 to 140/min and compression durations (duty cycles) from 10 to 90% of cycle time, cardiac output (CO) was predicted by the equation:where CR is compression rate, DC is duty cycle, SVmax (19 ml) is the effective capacity of the pumping chamber, and kl (0.00207 min) and k2 (0.00707 min) are ejection and filling constants. This expression predicts maximal CO for DC = 0.40 and CR = 126/min as well as 90-100% of maximal CO for 0.3 < DC < 0.5 and 70 < CR < 150/min. Such mathematical analysis may prove useful in the optimization of CPR.

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Section: Manipulation Of Compression Rate and Duration: Experimentssupporting

confidence: 84%

“…Instructional guidelines (l), supported by some research (3,8,15), strongly imply that the frequency of sternal compression is critical to adequate performance of external cardiopulmonary resuscitation (CPR). Rhythm and counting to achieve the correct overall rate of 60/min are emphasized in practical CPR instruction.…”

Section: Introductionmentioning

confidence: 99%

Cardiac output during cardiopulmonary resuscitation at various compression rates and durations

Fitzgerald¹,

Babbs²,

Frissora³

et al. 1981

American Journal of Physiology-Heart and Circulatory Physiology

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“…The favorable physiologic effects observed with high-impulse external cardiac massage in the dog seem to justify judicious human application, including more detailed hemodynamic studies in patients during cardiac arrest. In addition, previous experimental data and clinical experience25 26 …”

Section: Discussionmentioning

confidence: 99%

The physiology of external cardiac massage: high-impulse cardiopulmonary resuscitation.

Maier¹,

Tyson²,

Olsen³

et al. 1984

Circulation

266

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In intact chronically instrumented dogs, left ventricular dynamics were studied during cardiopulmonary resuscitation (CPR). Electromagnetic flow probes measured cardiac output and coronary blood flow, ultrasonic transducers measured cardiac dimensions, and micromanometers measured left ventricular, right ventricular, aortic, and intrathoracic pressures. The dogs were anesthetized with morphine, intubated, and fibrillated by rapid ventricular pacing. Data were obtained during manual external massage with dogs in the lateral and supine positions. Force of compression was varied from a peak intrathoracic pressure of 10 to 30 mm Hg, and compression rate was varied from 60 to 150/ min. Increasing force of compression increased stroke volume up to a peak intrathoracic pressure of approximately 20 mm Hg, beyond which stroke volume remained constant or declined. Stroke volume appeared to result primarily from direct transmission of manual compression force to the heart rather than from positive intrathoracic pressure because peak cardiac or vascular pressures or the change in these pressures were consistently two to four times greater than the corresponding intrathoracic pressures during manual compression. With increasing compression rate, stroke volume remained relatively constant, and total cardiac output increased significantly: 425 + 92 ml/min at 60/min, 643 130 ml/min at 100/min, and 975 ± 219 ml/min at 150/min (p < .05). Left ventricular dimensions decreased minimally at higher manual compression rates. In four patients undergoing CPR, systolic and diastolic arterial blood pressure increased with faster compression rates, correlating well with data obtained in the dog. Dynamic coronary blood flow in canine experiments decreased to zero or negative values during compression. Antegrade coronary flow occurred primarily during noncompression periods and seemed to be related to diastolic aortic perfusion pressure; coronary flow at a compression rate of 150/min averaged 75% of control. Therefore stroke volume and coronary blood flow in this canine preparation were maximized with manual chest compression performed with moderate force and brief duration. Increasing rate of compression increased total cardiac output while coronary blood flow was well maintained. Direct cardiac compression appeared to be the major determinant of stroke volume during manual external cardiac massage.

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“…While no studies exist comparing outcomes in OC-CPR and CC-CPR in humans there are many performed on dogs echoing the findings of Pike et al showing the superior hemodynamics, higher success rate in achieving ROSC, improved cerebral perfusion and superior outcomes in dogs receiving OC-CPR compared to CC-CPR [4][5][6][7][8].…”

Section: Disclosurementioning

confidence: 99%

Open chest CPR in non-traumatic cardiac arrest: A case report and review of the literature

Lundgren¹,

Sh²,

Ar³

et al. 2017

Trauma Emerg Care

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Hemodynamic effects of closed and open chest cardiac resuscitation in normal dogs and those with acute myocardial infarction

Cited by 100 publications

References 20 publications

Cardiac output during cardiopulmonary resuscitation at various compression rates and durations

Cardiac output during cardiopulmonary resuscitation at various compression rates and durations

The physiology of external cardiac massage: high-impulse cardiopulmonary resuscitation.

Open chest CPR in non-traumatic cardiac arrest: A case report and review of the literature

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