Optimizing hemodynamic function during cardiopulmonary resuscitation
| Autor: | Lauge Vammen, Asger Granfeldt, Kasper M. Hansen, Jesper Fjølner |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment education Hemodynamics Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Internal medicine Pressure medicine Animals Humans cardiovascular diseases Cardiopulmonary resuscitation Cerebral perfusion pressure Aorta business.industry 030208 emergency & critical care medicine Forward flow Balloon Occlusion Cardiopulmonary Resuscitation medicine.anatomical_structure 030228 respiratory system Balloon occlusion Ventricle Cardiology Narrative review business Perfusion |
| Zdroj: | Vammen, L, Fjølner, J, Hansen, K & Granfeldt, A 2021, ' Optimizing hemodynamic function during cardiopulmonary resuscitation ', Current Opinion in Critical Care, vol. 27, no. 3, pp. 216-222 . https://doi.org/10.1097/MCC.0000000000000819 |
| ISSN: | 1531-7072 1070-5295 |
| Popis: | PURPOSE OF REVIEW: The purpose of this narrative review is to provide an update on hemodynamics during cardiopulmonary resuscitation (CPR) and to describe emerging therapies to optimize perfusion.RECENT FINDINGS: Cadaver studies have shown large inter-individual variations in blood distribution and anatomical placement of the heart during chest compressions. Using advanced CT techniques the studies have demonstrated atrial and slight right ventricular compression, but no direct compression of the left ventricle. A hemodynamic-directed CPR strategy may overcome this by allowing individualized hand-placement, drug dosing, and compression rate and depth. Through animal studies and one clinical before-and-after study head-up CPR has shown promising results as a potential strategy to improve cerebral perfusion. Two studies have demonstrated that placement of an endovascular balloon occlusion in the aorta (REBOA) can be performed during ongoing CPR.SUMMARY: Modern imaging techniques may help increase our understanding on the mechanism of forward flow during CPR. This could provide new information on how to optimize perfusion. Head-up CPR and the use of REBOA during CPR are novel methods that might improve cerebral perfusion during CPR; both techniques do, however, still await clinical testing. |
| Databáze: | OpenAIRE |
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