Interposed abdominal compression-cardiopulmonary resuscitation and resuscitation outcome during asystole and electromechanical dissociation.

Sack, Jeffrey B.; Kesselbrenner, Michael B.; Jarrad, Anwar

doi:10.1161/01.cir.86.6.1692

Cited by 111 publications

(81 citation statements)

References 38 publications

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“…Acute hemodynamics (BP, ETCO 2  crossover) [33][34][35][36][37][38][39] All arrests (mostly VF) 1,40 Difficult arrests (EMD, asystole, prolonged) 41,42 For most end points results for IAC-CPR were between 1.5 and 2.0 times those for comparable standard CPR without abdominal compression.…”

Section: Model Class Subtypes Resultsmentioning

confidence: 99%

“…Three randomized clinical trials of IAC-CPR for in-hospital cardiac arrest have shown statistically significant improvement of outcome measures 1,41 . One randomized trial of pre-hospital IAC-CPR, combined when possible with standard CPR in the field, showed no difference in outcome or in complications 53 .…”

Section: Efficacy Of Iac-cprmentioning

confidence: 99%

“…These include all available survival data from the three in-hospital trials and one and outof-hospital trial 1,33,40,41 . That is, hemodynamic data were not considered.…”

Section: Meta-analysismentioning

confidence: 99%

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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: Model Class Subtypes Resultsmentioning

confidence: 99%

Section: Efficacy Of Iac-cprmentioning

confidence: 99%

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Interposed abdominal compression CPR: a comprehensive evidence based review

Babbs

2003

Resuscitation

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“…Dies fördert den venösen Rückstrom zum Herzen während der Reanimation [536,537] und verbessert sowohl die ROSC-Rate als auch das Kurzzeitüberleben [538,539]. Zwei Studien zur innerklinischen Reanimation wiesen eine erhöhte Krankenhausentlassungsrate nach Anwendung der IAC-CPR im Vergleich zur Standard-CPR nach [538,539]; eine weitere Studie zeigte keinen Überle-bensvorteil [540].…”

Section: Interponierte Abdominale Kompressionunclassified

Erweiterte Reanimationsmaßnahmen für Erwachsene („advanced life support“)

Deakin

Nolan

Soar

et al. 2010

Notfall Rettungsmed

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“…Such an individual has an extremely grave prognosis, 36 and successful restoration of spontaneous circulation may be more dependent on the maintenance of adequate coronary perfusion pressure than on restoration of spontaneous circulation in patients who have ventricular fibrillation or ventricular tachycardia. In a subsequent prospective study of 143 patients with in-hospital cardiac arrest from either asystole or EMD, Sack and coworkers 37 demonstrated a statistically significant improvement in immediate resuscitation outcome and 24-hour survival with the addition of interposed abdominal compressions to otherwise standard CPR. 37 Immediate resuscitation rates (28% versus 48%) and 24 hour survival rates (13% versus 33%) were better with IAC-CPR than with standard CPR.…”

Section: Clinical Studiesmentioning

confidence: 99%

The Evolution of Abdominal Compression in Cardiopulmonary Resuscitation

Babbs

1994

Academic Emergency Medicine

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Objective: To review the history of external abdominal compression as an adjunct to cardiopulmonary resuscitation (CPR), tracking the development of five major themes over the course of the 20th century: 1) augmentation of peripheral resistance by physical means, 2) risk of hepatic injury with abdominal compression, 3) counterpulsation vs sustained compression, 4) the abdominal pump mechanism, and 5) contact compression techniques. Methods: Literature retrieved from successive MEDLINE English‐language searches was reviewed with a special emphasis on work and concepts highlighted by participants at the First Purdue Conference on Interposed Abdominal Compression‐CPR, September 1992. Results: External abdominal compression of one form or another has been studied as a means of resuscitation by many investigators throughout the 20th century. Experimental and clinical studies have shown generally consistent evidence of hemodynamic augmentation by abdominal compression during various forms of CPR. Recent advances include a modified theoretical understanding of hemodynamic mechanisms and demonstration of clinical potential in humans. Inconsistencies in published results may be due to differences in mechanical techniques of abdominal compression. Based on these studies, a modified manual technique for “contact compression” of the abdominal aorta is recommended. Conclusions: A technique for left‐of‐center, angled compression of the abdominal aorta against the crest of the spine is recommended. Further well‐supervised and controlled clinical trials using this standardized technique are warranted as a prelude to more widespread clinical application of abdominal compression in CPR.

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Interposed abdominal compression-cardiopulmonary resuscitation and resuscitation outcome during asystole and electromechanical dissociation.

Abstract: We conclude that the addition of interposed abdominal compression may be a useful adjunct to otherwise standard CPR that can improve resuscitation outcome of patients experiencing in-hospital cardiac arrest from asystole and electromechanical dissociation.

Cited by 111 publications

References 38 publications

Interposed abdominal compression CPR: a comprehensive evidence based review

Interposed abdominal compression CPR: a comprehensive evidence based review

Erweiterte Reanimationsmaßnahmen für Erwachsene („advanced life support“)

The Evolution of Abdominal Compression in Cardiopulmonary Resuscitation

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