The effect of applied chest compression force on systemic arterial pressure and endtidal carbon dioxide concentration during CPR in human beings

Modeling in Cardiopulmonary Resuscitation: Pumping the Heart

“…Clinically, whether the support actually exists is still controversial, although reports have describing the heart to be fixed within the mediastinum by the pericardium (Kouwenhoven et al, 1960;Deshmukh et al, 1985). The improved effect of increasing p e (t) is in line with experimental findings (Ornato et al, 1989). A limitation is the compression frequency of 1 Hz, while current clinical practice is 100 compressions min −1 and the higher frequency may improve cardiac output (Maier et al, 1986) As Fig.…”

“…10. In both cases the superimposed oscillations are due to direct ventricular, cyclic, application of p e (t), as would be done during clinical CPR (Ornato et al, 1989). This means that a heart contracting without valves, or during CPR applied to a ventricle without competent valves, forces an insignificant amount of blood through the peripheral resistance.…”

Part 5: Adult Basic Life Support

“…These findings are supported by 3 swine studies (LOE 5 78 -80 ) showing improved survival with deeper compression depths and 1 adult human study (LOE 4 81 ) showing that improved force on the chest produced a linear increase in systolic blood pressure. However, 1 swine study (LOE 5 82 ) reported no improvement of myocardial blood flow with increased compression depth from 4 cm to 5 cm, although coronary perfusion pressure (CPP) improved from 7 to 14 mm Hg.…”

Compression of the Left Ventricular Outflow Tract During Cardiopulmonary Resuscitation

“…7,8 Many researchers have made efforts to improve the hemodynamic efficacy of external chest compression during CPR by focusing on the depth or rate of compression. 9,10 The 2005 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiac Care Science with Treatment Recommendation recommends that the rescuer place his or her hands on the lower half of the victim's sternum, at the center of the chest between the nipples, and depress the sternum approximately 4 to 5 cm. 11 The European Resuscitation Council also recommends the middle of the lower half of the sternum as the correct hand position for external chest compression.…”