Interposed abdominal compression-cardiopulmonary resuscitation and resuscitation outcome during asystole and electromechanical dissociation
| Autor: | J. B. Sack, M. B. Kesselbrenner, Anwar A. Jarrad |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Adult
Male Resuscitation Time Factors Vomiting medicine.medical_treatment Return of spontaneous circulation Heart Rate Physiology (medical) Heart rate Abdomen medicine Pressure Humans Cardiopulmonary resuscitation Asystole Aged Aged 80 and over business.industry Middle Aged medicine.disease Survival Analysis Heart Arrest Electrophysiology medicine.anatomical_structure Blood pressure Treatment Outcome Anesthesia Blood Circulation Multivariate Analysis Coronary perfusion pressure Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation. 86(6) |
| ISSN: | 0009-7322 |
| Popis: | BACKGROUND Coronary perfusion pressure has been shown to be a significant determinant of return of spontaneous circulation from cardiac arrest during asystole and electromechanical dissociation. The addition of interposed abdominal compression to otherwise standard cardiopulmonary resuscitation (CPR) increases coronary perfusion pressure in animal and human models. METHODS AND RESULTS Accordingly, we conducted a randomized prospective study of 143 consecutive patients experiencing cardiac arrest in a large university-affiliated teaching hospital in whom the initial arrest rhythm was asystole or electromechanical dissociation. Patients were randomized to receive either interposed abdominal compression-CPR or standard CPR. The two end points studied were return of spontaneous circulation and 24-hour survival. In addition, we studied the complications associated with interposed abdominal compression-CPR. Sixty-nine men and 74 women with a mean age of 64 years (range, 19-97 years) were studied. The overall rate of return of spontaneous circulation was 38%. Return of spontaneous circulation was significantly greater in the group receiving interposed abdominal compression-CPR compared with the group receiving standard CPR (49% versus 28%, p = 0.01). At 24 hours, there was a significantly greater number of patients alive in the experimental group than in the control group (33% versus 13%, p = 0.009). We found no complication directly related to the procedure of interposed abdominal compression in a small subset of patients who died and underwent necropsy. CONCLUSIONS 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. |
| Databáze: | OpenAIRE |
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