Enhanced external counterpulsation improves cerebral blood flow following cardiopulmonary resuscitation

Rong Liu, Zi Jing Liang, Xiao Xing Liao, Chun Lin Hu, Li Jiang, Gang Dai, Ying Qing Li, Hong Yan Wei, Gui Fu Wu, Xin Li

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background To investigate the therapeutic value of enhanced external counterpulsation (EECP) on recovery of cerebral blood flow following cardiac arrest (CA) and successful resumption of spontaneous circulation (ROSC) by cardiopulmonary resuscitation. Methods CA models were conducted using beagle dogs induced by alternating current. After successful ROSC by cardiopulmonary resuscitation, 16 dogs were randomly divided into the EECP and control group (n = 8 per group). Dogs underwent dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging at baseline prior to CA and during the 3 days following ROSC. Mean blood pressure, right common carotid artery blood flow, intracranial microcirculation and blood lactate levels were measured. Neurological outcome was assessed by the neurologic deficit score. Hematoxylin-eosin staining and transmission electron microscopy were performed for morphology and microconstruction of the cerebral cortex. Results The EECP group exhibited a significant elevation in right common carotid artery blood flow, intracranial microcirculation and a substantial decrease in blood lactate levels relative to the control group. Relative cerebral blood flow and volume were higher in the EECP group during the 3 days. Apparent diffusion coefficients were significantly higher in the EECP group on the first and third days. After ROSC, the neurologic deficit score was significantly higher in the control group compared to those in the EECP group during the three days of experiment. The cell swelling of neurons and increase of mitochondrial mass were more pronounced in the control group. Conclusion EECP is beneficial for recovery of cerebral blood flow and attenuation of ischemic cerebral edema following CA and successful ROSC.

Original languageEnglish (US)
Pages (from-to)1638-1645
Number of pages8
JournalAmerican Journal of Emergency Medicine
Issue number12
StatePublished - Dec 2013
Externally publishedYes


  • Abbreviations
  • ADC
  • apparent diffusion coefficient
  • CA
  • cardiac arrest
  • cardiopulmonary resuscitation
  • computed tomography
  • CPR
  • CT
  • diffusion-weighted MRI
  • DW-MRI
  • dynamic contrast-enhanced MRI
  • echo-planar imaging
  • EECP
  • enhanced external counterpulsation
  • EPI
  • field of view
  • FOV
  • gadolinium diethylenetriamine pentaacetic acid
  • Gd-DTPA
  • magnetic resonance imaging
  • MBP
  • mean blood pressure
  • mean quantity
  • mean transit time
  • MQ
  • MRI
  • MTT
  • RCBF
  • RCBV
  • RCCA
  • regions of interest
  • relative cerebral blood flow
  • relative cerebral blood volume
  • resumption of spontaneous circulation
  • return of spontaneous circulation
  • right common carotid artery
  • ROIs
  • ROSC
  • SE
  • spin echo
  • TE
  • TICs
  • time of echo
  • time of repetition
  • time to peak
  • time-intensity curves
  • TR
  • TTP
  • ventricular fibrillation
  • VF

ASJC Scopus subject areas

  • Emergency Medicine
  • Medicine(all)


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