Abdominal Binding during Cardiopulmonary Resuscitation in Man

Chandra, Nisha; Snyder, Louis D.; Weisfeldt, Myron L.

doi:10.1097/00132586-198202000-00032

Cited by 3 publications

(4 citation statements)

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“…In contrast, Chandra and Rudikoff and their coworkers at Johns Hopkins reported several CPR studies using sustained abdominal binding in animals and in humans that suggest that elevated blood pressures and flows can be achieved without liver damage [9,27]. In a series of 15 dogs, they found that tightly binding the abdomen over an inflatable bladder with adhesive tape from the xyphoid to the iliac crest increased aortic systolic pressure from 28 to 57 mm Hg and carotid blood flow from 14 to 32 ml/min [27].…”

Section: Sustained Abdominal Compression During Cprmentioning

confidence: 98%

“…Carotid flow increased in 13 of the 15 dogs after abdominal binding, and there was no evidence of liver injury with mechanically controlled chest compression and abdominal binding in any of the 15 animals [27]. In Chandra's human studies [9], radial artery blood pressure was measured during brief (30-to 60-second) periods of abdominal binding in 10 patients experiencing cardiac arrest and standard CPR applied with a mechanical device. The abdomen was bound with an inflatable 30 -cm square bladder that was positioned anteriorly on the patient's abdomen, extending from the lower ribs to the anterior superior iliac spine, held in place by a large strap, and inflated to approximately 100 mm Hg.…”

Section: Sustained Abdominal Compression During Cprmentioning

confidence: 99%

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Abdominal Binding and Counterpulsation in Cardiopulmonary Resuscitation

Babbs

Blevins

1986

Critical Care Clinics

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The history and potential of abdominal pressure as an adjunct to standard cardiopulmonary resuscitation (CPR) is reviewed. Abdominal pressure during CPR may be either static or phasic. Static abdominal pressure redirects limited blood flow generated by chest compressions toward the heart and brain, and away from the abdominal organs and lower extremities, thus boosting coronary perfusion pressure. Phasic abdominal pressure applied whenever chest pressure is released, in counterpoint to the rhythm of chest compression-so called interposed abdominal compression (IAC)-CPR-generates blood flow by an independent abdominal pump mechanism that augments the systemic perfusion created by chest compressions. New imaging data are presented in the form of cardiac angiograms during CPR in anesthetized dogs, illustrating the effects of interposed abdominal compressions added to otherwise standard CPR. The benefits vs. risks of IAC-CPR are discussed.

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Section: Sustained Abdominal Compression During Cprmentioning

confidence: 98%

Section: Sustained Abdominal Compression During Cprmentioning

confidence: 99%

Abdominal Binding and Counterpulsation in Cardiopulmonary Resuscitation

Babbs

Blevins

1986

Critical Care Clinics

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“…10,11 In a series of 15 dogs they found that tightly binding the abdomen over an inflatable bladder with adhesive tape from the xyphoid to the iliac crest increased aortic systolic pressure from 28 to 57 torr and carotid blood flow from 14 to 32 mL/min. 11 Carotid flows increased in 13 of the 15 dogs after abdominal binding, and there was no evidence of liver injury with mechanically controlled chest compression and abdominal binding in any of the 15 animals.…”

Section: Sustained Abdominal Compression During Cprmentioning

confidence: 99%

The Evolution of Abdominal Compression in Cardiopulmonary Resuscitation

Babbs

1994

Academic Emergency Medicine

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Objective: To review the history of external abdominal compression as an adjunct to cardiopulmonary resuscitation (CPR), tracking the development of five major themes over the course of the 20th century: 1) augmentation of peripheral resistance by physical means, 2) risk of hepatic injury with abdominal compression, 3) counterpulsation vs sustained compression, 4) the abdominal pump mechanism, and 5) contact compression techniques. Methods: Literature retrieved from successive MEDLINE English‐language searches was reviewed with a special emphasis on work and concepts highlighted by participants at the First Purdue Conference on Interposed Abdominal Compression‐CPR, September 1992. Results: External abdominal compression of one form or another has been studied as a means of resuscitation by many investigators throughout the 20th century. Experimental and clinical studies have shown generally consistent evidence of hemodynamic augmentation by abdominal compression during various forms of CPR. Recent advances include a modified theoretical understanding of hemodynamic mechanisms and demonstration of clinical potential in humans. Inconsistencies in published results may be due to differences in mechanical techniques of abdominal compression. Based on these studies, a modified manual technique for “contact compression” of the abdominal aorta is recommended. Conclusions: A technique for left‐of‐center, angled compression of the abdominal aorta against the crest of the spine is recommended. Further well‐supervised and controlled clinical trials using this standardized technique are warranted as a prelude to more widespread clinical application of abdominal compression in CPR.

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“…Mechanically, several groups 5,[14][15][16][17] have explored the use of static abdominal binding to inhibit diastolic runoff from the thoracic aorta to nonvital vascular beds, and in turn to raise the aorticto-right atrial pressure gradient driving perfusion of the heart and brain. The major difficulty with static abdominal binding or continuous abdominal pressure as a means to achieve raised peripheral resistance during CPR is the danger that fatal hepatic trauma may occur as a result of splinting of the liver beneath the sternum at the time that chest compression is applied.…”

Section: Introductionmentioning

confidence: 99%

Interposed abdominal compression as an adjunct to cardiopulmonary resuscitation

Babbs¹,

Sack²,

Kern³

1994

Resuscitation

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The addition of interposed abdominal compression (IAC) to otherwise standard CPR provides external pressure over the abdomen in counterpoint to the rhythm of chest compression. Interposed abdominal compression is a simple manual technique that can supplement the use of adrenergic drugs to increase both coronary perfusion pressure and total blood flow during CPR. Mechanistically, manual abdominal compressions induce both central aortic and central venous pressure pulses. However, owing to differences in venous versus arterial capacitance, the former are usually greater than the latter, so that systemic perfusion pressure is enhanced. Moreover, practical experience and theoretical analysis have suggested subtle refinements in the hand position and technique for abdominal compression that may further improve the ratio of arterial to venous pressure augmentation. Clinical studies confirm that IAC-CPR can improve perfusion pressures and carbon dioxide excretion during CPR in humans. The incidence of abdominal trauma, regurgitation, or other complications is not increased by IAC. Randomized trials have shown that short-term and long-term survival of patients resuscitated in the hospital by IAC-CPR are about twice that of control patients resuscitated by standard CPR. The technique of IAC has thus evolved to become a highly promising adjunct to normal CPR, which is likely to be implemented in an increasing number of clinical protocols.

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Abdominal Binding during Cardiopulmonary Resuscitation in Man

Cited by 3 publications

References 0 publications

Abdominal Binding and Counterpulsation in Cardiopulmonary Resuscitation

Abdominal Binding and Counterpulsation in Cardiopulmonary Resuscitation

The Evolution of Abdominal Compression in Cardiopulmonary Resuscitation

Interposed abdominal compression as an adjunct to cardiopulmonary resuscitation

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