title: Right atrial-jugular venous pressure gradients during CPR in children.
abstract: OBJECTIVE
  This study measured the internal jugular vein and right atrium pressures during pediatric CPR to detect and quantify venous pressure gradients across the thoracic inlet.
  
  
  METHODS
  Ten children from 2 months to 15 years old who underwent CPR had simultaneous pressure measurements recorded from the right atrium and jugular vein.
  
  
  RESULTS
  The right atrium-jugular vein peak compression-phase gradient was 18.3 +/- 4.7 mm Hg (mean +/- SD), and the end-relaxation gradient was 0.7 +/- 0.6. Jugular vein pressure exceeded the right atrium only in the early-relaxation phase (right atrium-jugular vein = -2.1 +/- 1.2). Thoracic inlet venous valving persisted throughout the duration of CPR.
  
  
  CONCLUSIONS
  There is a large venous gradient across the thoracic inlet during chest compressions in children, facilitating cerebral blood flow. This gradient reversed only in the early-relaxation phase. The data suggest that jugular venous return occurs only in the early-relaxation phase, whereas cerebral venous drainage persists throughout the CPR cycle.
authors.affiliation: Department of Pediatrics, Henry Ford Hospital, Detroit, Michigan 48202.
authors.forename: M G
authors.initials: MG
authors.lastname: Goetting
authors.forename: N A
authors.initials: NA
authors.lastname: Paradis
mesh_terms: D000293:Adolescent; D002560:Cerebrovascular Circulation / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007601:Jugular Veins / Q000503:physiopathology; D012151:Resuscitation; D014690:Venous Pressure