Effects of incomplete chest wall decompression during cardiopulmonary resuscitation on coronary and cerebral perfusion pressures in a porcine model of cardiac arrest

Yannopoulos, Demetris; McKnite, Scott; Aufderheide, Tom P.; Sigurðsson, Garðar; Pirrallo, Ronald G.; Benditt, David G.; Lurie, Keith G.

doi:10.1016/j.resuscitation.2004.10.009

Cited by 265 publications

(145 citation statements)

References 21 publications

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“…[7] The above fi ndings revealed that fast compression would lead to premature fatigue, eventually shallow compression depth, inaccurate hands location, decreased compression rate, [15] and worse chest wall recoil. [16] Therefore, the operator could improve the quality of chest compression by controlling the frequency to delay the fatigue, especially to keep enough compression depth and chest wall recoil, and to eliminate the invalid compression and elevate the effect of chest compression.…”

Section: The Relationship Between the Quality Indexes Of Chest Comprementioning

confidence: 99%

Correlations between quality indexes of chest compression

Zhang¹,

Li²,

Huang³

et al. 2013

World Journal of Emergency Medicine

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Section: The Relationship Between the Quality Indexes Of Chest Comprementioning

confidence: 99%

Correlations between quality indexes of chest compression

Zhang¹,

Li²,

Huang³

et al. 2013

World Journal of Emergency Medicine

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“…A small change in compression to ventilation ratio in pigs from 15:2 to 15:1 resulted in an increase in diastolic aortic pressure and higher cerebral perfusion pressures. [9][10][11][12][13] Studies in anaesthetised adults with normal perfusion suggest that normal oxygenation and elimination of CO 2 can be maintained at tidal volumes of 8 to10 mL/kg. 14,15 As cardiac output drops to less than 20% during CPR, lower tidal volumes and rates can maintain effective oxygenation and ventilation during CPR.…”

Section: Discussionmentioning

confidence: 99%

Use of a Load Distributing Band Device (with Ventilation Prompts) during Cardiopulmonary Resuscitation

Annathurai

Fook‐Chong

et al. 2015

Hong Kong Journal of Emergency Medicine

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Introduction: Over-ventilation can compromise coronary perfusion pressures during cardiopulmonary resuscitation (CPR) and should be minimised. We compared ventilations during manual and mechanical (load-distributing band -LDB) CPR, which gives ventilation prompts. Our primary objective was to compare the ventilation rate between manual CPR and LDB-CPR. Method: This was a phased, non-randomised study at a tertiary hospital emergency department. All out-of-hospital, non-traumatic cardiac arrest adult patients during the study period from February 2007 till July 2008 were eligible. Pregnant females and patients aged less than 18 years of age were excluded. Ventilation rates in the first and second 5 minutes segments were recorded. Over-ventilation was defined as ventilation rate above 12 breaths per minute. All data analyses were performed with SPSS, version 17.0. Mean differences with 95% confidence interval (CI) were compared between the 2 treatment groups. Results: From February 2007 till August 2007, there were 29 patients with manual CPR; and from September 2007 till July 2008, there were 62 with LDB-CPR. In the first 5 minutes of CPR, the proportion of patients that were over-ventilated, was 27.6% (manual) and 4.8% (LDB) (difference = 22.7%; 95% CI: 3.5-46.4%). In the next 5 minutes, the proportion of patients that were over-ventilated was 37.9% and 1.6% for manual and mechanical CPR respectively (difference = 36.3%; 95% CI: 16.5-58.9%). Conclusion: Over-ventilation is reduced significantly in LDB-CPR compared to manual CPR during the first and second 5 minutes of resuscitation.

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“…34, 35 The small negative intrathoracic pressure generated within the thorax during the chest wall recoil phase is critical for refilling the heart during the decompression phase of CPR. 4 If chest compressions are not deep enough then chest recoil can be impaired. 36 It has recently been demonstrated that when compressions are too rapid, the compression depth is too shallow.…”

Section: Mechanophysiology Of Cpr and The Itdmentioning

confidence: 99%