TY - JOUR
T1 - SIMULTANEOUS CHEST COMPRESSION AND VENTILATION AT HIGH AIRWAY PRESSURE DURING CARDIOPULMONARY RESUSCITATION
AU - Chandra, Nisha
AU - Rudikoff, Michael
AU - Weisfeldt, Myron L.
N1 - Funding Information:
This study is part of a research programme into the development of liver support systems supported by the Medical Research Council, and we also thank Smith & Nephew Research Ltd and Wellcome Research Laboratories for their support.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1980/1/26
Y1 - 1980/1/26
N2 - In most patients blood flow during cardiopulmonary resuscitation (CPR) results from a rise in intrathoracic pressure rather than from direct heart compression. Intrathoracic pressure was increased by the use of positive-pressure ventilation synchronous with sternal compression in eleven arrested patients who were intubated. A computer system allowed 15-30 s periods of alternation between conventional CPR and "new CPR" (rate of 40/min, 60% compression duration, and simultaneous ventilation at airway pressures from 60 to 110 cm H2O). Compression force was identical with the two methods. New CPR increased mean systolic radial artery pressure significantly from 40·6±4·4 to 53·1±3·9 mm Hg for 14 runs in nine patients. In 15 runs in ten patients an index of carotid flow increased with new CPR to 252% (range 113-643%) of control values. Lowering airway pressure during new CPR lowered flow index and arterial pressure, confirming that these increases with new CPR were due to higher intrathoracic pressure. Thus, increased airway pressure synchronous with sternal compression increases arterial pressure and likely blood flow during CPR in man. However, further studies of potential complications and long-term effects of new CPR, particularly on adequacy of ventilation, are needed before clinical implementation is undertaken.
AB - In most patients blood flow during cardiopulmonary resuscitation (CPR) results from a rise in intrathoracic pressure rather than from direct heart compression. Intrathoracic pressure was increased by the use of positive-pressure ventilation synchronous with sternal compression in eleven arrested patients who were intubated. A computer system allowed 15-30 s periods of alternation between conventional CPR and "new CPR" (rate of 40/min, 60% compression duration, and simultaneous ventilation at airway pressures from 60 to 110 cm H2O). Compression force was identical with the two methods. New CPR increased mean systolic radial artery pressure significantly from 40·6±4·4 to 53·1±3·9 mm Hg for 14 runs in nine patients. In 15 runs in ten patients an index of carotid flow increased with new CPR to 252% (range 113-643%) of control values. Lowering airway pressure during new CPR lowered flow index and arterial pressure, confirming that these increases with new CPR were due to higher intrathoracic pressure. Thus, increased airway pressure synchronous with sternal compression increases arterial pressure and likely blood flow during CPR in man. However, further studies of potential complications and long-term effects of new CPR, particularly on adequacy of ventilation, are needed before clinical implementation is undertaken.
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U2 - 10.1016/S0140-6736(80)90662-5
DO - 10.1016/S0140-6736(80)90662-5
M3 - Article
C2 - 6101633
AN - SCOPUS:0018917333
SN - 0140-6736
VL - 315
SP - 175
EP - 178
JO - The Lancet
JF - The Lancet
IS - 8161
ER -