The Effect of Head Up Cardiopulmonary Resuscitation on Cerebral and Systemic Hemodynamics

Resuscitation
Hyun Ho RyuKeith G Lurie

Abstract

Chest compressions during cardiopulmonary resuscitation (CPR) increase arterial and venous pressures, delivering simultaneous bidirectional high-pressure compression waves to the brain. We hypothesized that this may be detrimental and could be partially overcome by elevation of the head during CPR. Female Yorkshire farm pigs (n=30) were sedated, intubated, anesthetized, and placed on a table able to elevate the head 30° (15cm) (HUP) and the heart 10° (4cm) or remain in the supine (SUP) flat position during CPR. After 8minutes of untreated ventricular fibrillation and 2minutes of SUP CPR, pigs were randomized to HUP or SUP CPR for 20 more minutes. In Group A, pigs were randomized after 2minutes of flat automated conventional (C) CPR to HUP (n=7) or SUP (n=7) C-CPR. In Group B, pigs were randomized after 2minutes of automated active compression decompression (ACD) CPR plus an impedance threshold device (ITD) SUP CPR to either HUP (n=8) or SUP (n=8). The primary outcome of the study was difference in CerPP (mmHg) between the HUP and SUP positions within groups. After 22minutes of CPR, CerPP was 6±3mmHg in the HUP versus -5±3 in the SUP (p=0.016) in Group A, and 51±8 versus 20±5 (p=0.006) in Group B. Coronary perfusion pressures af...Continue Reading

References

Sep 2, 2011·The New England Journal of Medicine·Tom P AufderheideUNKNOWN Resuscitation Outcomes Consortium (ROC) Investigators

❮ Previous
Next ❯

Citations

Mar 28, 2017·Current Opinion in Critical Care·Johanna C MooreDemetris Yannopoulos
Oct 2, 2019·Clinical and Experimental Emergency Medicine·Yong Joo ParkHyun Ho Ryu
Mar 21, 2021·Best Practice & Research. Clinical Anaesthesiology·Hans van SchuppenMarkus W Hollmann
Mar 27, 2021·Current Opinion in Critical Care·Lauge VammenAsger Granfeldt
May 27, 2021·Critical Care : the Official Journal of the Critical Care Forum·Youcef AzeliMaria F Jiménez-Herrera
Aug 10, 2021·Journal of the American Heart Association·James M HorowitzFelipe Teran

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.