Active compression-decompression resuscitation: A novel method of cardiopulmonary resuscitation

Cohen, Todd J.; Tucker, Kelly J.; Redberg, Rita F.; Lurie, Keith G.; Chin, Michael C.; Dutton, J.; Scheinman, Melvin M.; Schiller, Nelson B.; Callaham, Michael L.

doi:10.1016/0002-8703(92)90393-a

Cited by 97 publications

(25 citation statements)

References 27 publications

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“…5 The peak systolic method, as described by Niemann et al 1982, and Raessler et al 1988 Fig . 6 The diastolic mean method, as described by Fenely et al 1988, Cohen et al 1992, and Wik et al 1996 Fig . 7 The true mean method, as described by Geddes et al 2007, Niemann et al 1985, Babbs 2006, and Jung et al 2006 Results Table 1 displays the CPP for the normally beating heart immediately before the episode of VF and the CPP provided by standard CPR (performed according to the 2005 AHA guidelines) during VF, as calculated by each of the CPP methods.…”

Section: Methodsmentioning

confidence: 99%

“…Investigators have tested various compression forces, rates, and duty cycles, investigated interposed chest and abdominal compressions, and proposed rhythmic abdominal compressions only (Maier et al 1984;Criley et al 1976;Halperin et al 1993Halperin et al , 2004Ralston et al1982;Babbs 1993;, as well as adjunct devices to be applied during CPR to enhance its positive effects Cohen et al 1992;Mauer et al 1999;Lurie et al 1990Lurie et al , 2001Lurie et al , 2002Tang et al 1997). To evaluate and compare the effectiveness of the various types of CPR compressions and devices, a metric must be chosen that will describe how well each method maintains coronary and systemic blood flow during cardiac arrest and CPR.…”

Section: Introductionmentioning

confidence: 99%

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Methods for Calculating Coronary Perfusion Pressure During CPR

et al. 2009

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Coronary perfusion pressure (CPP) is a major indicator of the effectiveness of cardiopulmonary resuscitation in human and animal research studies; however methods for calculating CPP differ among research groups. Here we compare the 6 published methods for calculating CPP using the same data set of aortic (Ao) and right atrial (RA) blood pressures. CPP was computed using each of the 6 calculation methods in an anesthetized pig model, instrumented with catheters with Cobe pressure transducers. Aortic and right atrial pressures were recorded continuously during electrically induced ventricular fibrillation and standard CPR. CPP calculated from the same raw data set by the 6 calculation methods ranged from -1 (signifying retrograde blood flow) to 26 mmHg (mean ± SD of 15 ± 11 mmHg). The CPP achieved by standard closed chest CPR is typically reported as 10-20 mmHg. Within a single study the CPP values may be comparable; however, the CPP values for different studies may not be reliable indicators of the relative efficacies of different CPR methods. Electronically derived, true mean coronary perfusion pressure is arguably the gold standard metric for representing coronary perfusion pressure.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Methods for Calculating Coronary Perfusion Pressure During CPR

et al. 2009

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“…266,267 ACD-CPR maintains coronary perfusion during compression and decompression in humans 268,269 and provides ventilation if the airway is patent. 268,270 In clinical trials ACD-CPR has produced variable results, including improved short-term outcome (eg, return of spontaneous circulation and survival for 24 hours). [271][272][273][274] However, these improved outcomes are not consistent, 275 and no long-term survival benefits of ACD-CPR have been reported in most trials.…”

Section: Circulatory Adjuncts and Mechanical Devices For Chest Comprementioning

confidence: 99%

Part 9: Pediatric Basic Life Support

2000

Circulation

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• The extremely complex skills sequence for lay rescuer relief of foreign-body airway obstruction (FBAO) in the unconscious victim has been simplified. The sequence for healthcare provider relief of FBAO in the unconscious victim remains unchanged (Class IIb). IntroductionPediatric BLS refers to the provision of CPR, with no devices or with bag-mask ventilation or barrier devices, until advanced life support (ALS) can be provided. The population addressed in this chapter includes infants from birth to 1 year of age and children from 1 to 8 years of age. CPR and life support in the pediatric age group should be part of a community-wide Chain of Survival that links the child to the best hope of survival following emergencies. The Chain of Survival integrates education in prevention of cardiopulmonary arrest, BLS, early access to EMS systems prepared for children's needs, early and effective pediatric Sudden cardiopulmonary arrest in infants and children is much less common than sudden cardiac arrest in adults. 4 In contrast to cardiac arrest in adults, cardiac arrest in infants and children is rarely a sudden event, and non-cardiac causes predominate. 4 The etiology of cardiac arrest in infants and children varies by age, setting, and the underlying health of the child. For these reasons, the sequence of CPR for infants and children requires a different approach from that used for adult victims.Cardiac arrest in the under-21-year-old age group occurs most commonly at either end of the age spectrum: under 1 year of age and during the teenage years. In the newly born infant, respiratory failure is the most common cause of cardiopulmonary deterioration and arrest. During infancy the most common causes of arrest include sudden infant death syndrome (SIDS), respiratory diseases, airway obstruction (including foreign-body aspiration), submersion, sepsis, and neurological disease. [5][6][7][8][9][10][11] Beyond 1 year of age, injuries are the leading cause of death. [12][13][14] Cardiac arrest in children typically represents the terminal event of progressive shock or respiratory failure. Either shock or respiratory failure may include a compensated state from which children can rapidly deteriorate to a decompensated condition with progression to respiratory or cardiac arrest. Therefore, rescuers must detect and promptly treat early signs of respiratory and circulatory failure to prevent cardiac arrest. In children, early effective bystander CPR has been associated with successful return of spontaneous circulation and neurologically intact survival. 15,16 BLS courses should be offered to target populations such as expectant parents, child care providers, teachers, sports supervisors, and others who regularly care for children. Parents and child care providers of children with underlying conditions that predispose them to cardiopulmonary failure should be particularly targeted for these courses.These guidelines are based on a review and analysis of clinical and experimental evidence. 17 Because this evidence varies widely...

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“…Der dem Effekt der ACD-CPR zugrunde liegende Mechanismus in der aktiven Dekompressionsphase ist wahrscheinlich ein erhöh-ter venöser Rückstrom zum rechten Atrium durch die Anhebung des Thorax, der zu einer besseren linksventrikulären Füllung und bei der folgenden Thoraxkompression zu einer Steigerung des Herzzeitvolumens führt. In klinischen Studien konnte im Vergleich zur Standard-CPR mit ACD-CPR ein höheres linksventrikuläres Schlagvolumen [128], end-exspiratorisches Kohlendioxid [28], und 24-h-Überleben festgestellt werden [29,129]. Andere Studien fanden jedoch keine Unterschiede zwischen beiden Techniken [80,109,116].…”

Section: Introductionunclassified

Die neuen internationalen Richtlinien zur kardiopulmonalen Reanimation

et al. 2001

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In August 2000, the American Heart Association and the European Resuscitation Council published the conclusions of the International Guidelines 2000 Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care which contains both the new recommendations and an in-depth review. The discussions and drafting began at a conference in March 1999, followed by a second conference in September 1999, both attended by approx. 250 participants and another conference in February 2000 which was attended by approx. 500 participants. Review of the current state of science, discussion and final consensus continued subsequently via email, conference calls, fax, and personal conversation. During the entire process, scientists and resuscitation councils from all over the world participated, with participants from the United States comprising approx. 60%, and scientists from outside of the United States comprising approx. 40%. In order to ensure that the CPR recomendations are not dominated by any given nation or resuscitation council, most topics were reviewed and interpretated by two scientists from the United States and two scientists from outside of the United States. Accordingly, changes in these new CPR recommendations are the result of an evidence-based review by worldwide experts. The most important changes in the recommendations according to the authors are discontinuation of the pulse-check for lay people, 500 ml instead of 800-1200 ml tidal volume during bag-valve-mask ventilation (FiO2 > 0.4) of a patient with an unprotected airway, verifying correct endotracheal intubation with capnography and an esophageal detector, employing mechanical devices such as interposed abdominal compression CPR, vest CPR, active-compression-decompression CPR, and the inspiratory threshold valve (ITV) CPR as alternatives or adjuncts to standard manual chest compressions, defibrillation with < 200 Joule biphasic instead of with 200-360 Joule monophasic impulses, vasopressin (40 units) and epinephrine (1 mg) as comparable drugs to treat patients with ventricular fibrillation, amiodarone (300 mg) for shock-refractory ventricular fibrillation and intravenous lysis for patients who have suffered a stroke.

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Active compression-decompression resuscitation: A novel method of cardiopulmonary resuscitation

Cited by 97 publications

References 27 publications

Methods for Calculating Coronary Perfusion Pressure During CPR

Methods for Calculating Coronary Perfusion Pressure During CPR

Part 9: Pediatric Basic Life Support

Die neuen internationalen Richtlinien zur kardiopulmonalen Reanimation

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