Nov 14, 2001

Adverse hemodynamic effects of interrupting chest compressions for rescue breathing during cardiopulmonary resuscitation for ventricular fibrillation cardiac arrest

Circulation
Robert BergGordon A Ewy

Abstract

Despite improving arterial oxygen saturation and pH, bystander cardiopulmonary resuscitation (CPR) with chest compressions plus rescue breathing (CC+RB) has not improved survival from ventricular fibrillation (VF) compared with chest compressions alone (CC) in numerous animal models and 2 clinical investigations. After 3 minutes of untreated VF, 14 swine (32+/-1 kg) were randomly assigned to receive CC+RB or CC for 12 minutes, followed by advanced cardiac life support. All 14 animals survived 24 hours, 13 with good neurological outcome. For the CC+RB group, the aortic relaxation pressures routinely decreased during the 2 rescue breaths. Therefore, the mean coronary perfusion pressure of the first 2 compressions in each compression cycle was lower than those of the final 2 compressions (14+/-1 versus 21+/-2 mm Hg, P<0.001). During each minute of CPR, the number of chest compressions was also lower in the CC+RB group (62+/-1 versus 92+/-1 compressions, P<0.001). Consequently, the integrated coronary perfusion pressure was lower with CC+RB during each minute of CPR (P<0.05 for the first 8 minutes). Moreover, at 2 to 5 minutes of CPR, the median left ventricular blood flow by fluorescent microsphere technique was 60 mL. 100 g(-1). ...Continue Reading

  • References10
  • Citations325

Citations

Mentioned in this Paper

Coronary Circulation
Ventricular Fibrillation
Arterial Oxygen Saturation Measurement
Dioxygen
Diastolic Blood Pressure
Myocardium
Breath
Basic Cardiac Life Support
Blood Flow
Anterior Thoracic Region

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