title: The effect of applied chest compression force on systemic arterial pressure and end-tidal carbon dioxide concentration during CPR in human beings.
abstract: Twelve adult (nine men and three women) cardiac arrest patients were studied as they received CPR by a computerized Thumper to determine the influence of the applied chest compression force on blood flow (as assessed by the end-tidal carbon dioxide concentration) and arterial pressure. At the end of a resuscitation when the decision was made by the senior physician to cease resuscitative efforts, the applied force on the CPR Thumper was decreased from 140 to 0 pound-force (lbf) in 20-lbf increments at 30-second intervals. Radial artery cutdown blood pressure and end-tidal carbon dioxide (ETCO2) were recorded continuously. Arterial systolic blood pressure was linearly related (r = .59, P less than .0001) to applied force (systolic blood pressure, 31 +/- 6 mm Hg at 20 lbf to 60 +/- 7 mm Hg at 140 lbf). ETCO2 (r = .42, P less than .0001) was also linearly related to applied force (ETCO2, 0.7 +/- 0.1% at 20 lbf to 1.5 +/- 0.2% at 140 lbf). Diastolic pressure did not change significantly with change in applied force (17 +/- 2 mm Hg from 20 to 140 lbf). Our findings indicate that higher compression force than that currently recommended may improve arterial systolic pressure and flow in human beings receiving closed-chest compression during CPR.
authors.affiliation: Department of Internal Medicine (Cardiology), Medical College of Virginia, Richmond 23298.
authors.forename: J P
authors.initials: JP
authors.lastname: Ornato
authors.forename: R L
authors.initials: RL
authors.lastname: Levine
authors.forename: D S
authors.initials: DS
authors.lastname: Young
authors.forename: E M
authors.initials: EM
authors.lastname: Racht
authors.forename: A R
authors.initials: AR
authors.lastname: Garnett
authors.forename: E R
authors.initials: ER
authors.lastname: Gonzalez
mesh_terms: D001794:Blood Pressure; D001944:Breath Tests; D002245:Carbon Dioxide / Q000032:analysis*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012151:Resuscitation / Q000379:methods*
chemical_list: D002245:Carbon Dioxide