title: A comparison of interposed abdominal compression CPR and standard CPR by monitoring end-tidal PCO2.
abstract: Interposed abdominal compression CPR (IAC-CPR) has been demonstrated to significantly improve blood flow compared with standard (S)-CPR in animal and electrical models. Studies with IAC-CPR in human beings have not reported data regarding cardiac output. Animal and clinical studies have correlated end-tidal PCO2 (ETPCO2) with cardiac output produced with precordial compressions. We conducted a prospective, randomized study on 33 adult patients with nontraumatic cardiac arrest. Patients were randomized to initially receive either S-CPR or IAC-CPR. ETPCO2 was monitored continuously. After 20 minutes of resuscitation, the technique was reversed. The average ETPCO2 during IAC-CPR was 17.1 mm Hg while the average during S-CPR was 9.6 mm Hg, a difference of 78% (P less than .001). In patients arriving in cardiac arrest, return of spontaneous circulation was observed in six patients (30%) during IAC-CPR and in one patient (6%) during S-CPR (P = .07). Our study strongly suggests that cardiac output may be significantly increased in human beings with IAC-CPR as evidenced by the significantly greater increases in ETPCO2 with IAC-CPR compared with S-CPR. In addition, IAC-CPR appeared to demonstrate a trend toward increasing the return of spontaneous circulation.
authors.affiliation: Tulane University School of Medicine, New Orleans, Louisiana 70112.
authors.forename: K R
authors.initials: KR
authors.lastname: Ward
authors.forename: R J
authors.initials: RJ
authors.lastname: Sullivan
authors.forename: R R
authors.initials: RR
authors.lastname: Zelenak
authors.forename: W R
authors.initials: WR
authors.lastname: Summer
mesh_terms: D000005:Abdomen; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000628:therapy; D002245:Carbon Dioxide / Q000032:analysis*; D002302:Cardiac Output; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D006801:Humans; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011446:Prospective Studies; D012123:Pulmonary Ventilation; D011897:Random Allocation; D012151:Resuscitation / Q000379:methods*; D013990:Tidal Volume
chemical_list: D002245:Carbon Dioxide