Improving active compression-decompression cardiopulmonary resuscitation with an inspiratory impedance valve
| Autor: | Scott McKnite, Katherine A. Mulligan, Paul Coffeen, Barry L.S. Detloff, Jeffrey J. Shultz, Keith G. Lurie |
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| Rok vydání: | 1995 |
| Předmět: |
Resuscitation
Decompression Swine medicine.medical_treatment education Diastole Emergency Nursing Ventilation/perfusion ratio Physiology (medical) Ventilation-Perfusion Ratio Medicine Animals Cardiopulmonary resuscitation business.industry Pulmonary Gas Exchange Blood flow Impedance threshold device Compression (physics) medicine.disease Cardiopulmonary Resuscitation Heart Arrest Circulation (fluid dynamics) Regional Blood Flow Anesthesia Ventricular fibrillation Ventricular Fibrillation Emergency Medicine Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation. 91(6) |
| ISSN: | 0009-7322 |
| Popis: | Background Active compression-decompression (ACD) cardiopulmonary resuscitation (CPR) has recently been demonstrated to provide significantly more blood flow to vital organs during cardiac arrest. To further enhance the effectiveness of this technique, we tested the hypothesis that intermittent impedance to inspiratory gas exchange during the decompression phase of ACD CPR enhances vital organ blood flow. Methods and Results ACD CPR was performed with a pneumatically driven automated compression-decompression device in a porcine model of ventricular fibrillation (VF). Nine pigs were randomized to receive ACD CPR alone, while 8 pigs received ACD CPR plus intermittent impedance to inspiratory gas exchange with a threshold valve set to 40 cm H 2 O. Results comparing 2 minutes of ACD CPR alone versus ACD CPR with the inspiratory impedance threshold valve (ITV) revealed significantly higher mean (±SEM) coronary perfusion pressures (diastolic aortic minus diastolic right atrial pressures) in the ITV (31.0±2.3 mm Hg) group versus with ACD CPR alone (21±3.6 mm Hg) ( P P P P =.18). Conclusions Intermittent impedance to inspiratory flow of respiratory gases during ACD CPR significantly improves coronary perfusion pressures and vital organ blood flow and lowers defibrillation energy requirements in a porcine model of VF. |
| Databáze: | OpenAIRE |
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