Hemodynamic effects of active compression-decompression after prolonged CPR.
BACKGROUND
This study was designed to test the effects of active compression-decompression (ACD) versus standard (STD) cardiopulmonary resuscitation (CPR) on hemodynamics after prolonged cardiac arrest (CA).


RESULTS
After nontraumatic prehospital CA, 21 patients were resuscitated in a prospective nonblinded setting sequentially with STD and ACD CPR at the emergency department, if it had not been possible to achieve restoration of spontaneous circulation (ROSC) before admission. The compression rate was 80/min with a 50% duty cycle, and 1 mg epinephrine was given every 5th min. Invasive arterial, central venous pressure and end tidal CO2 (ETCO2) were monitored. Comparing coronary perfusion pressure (CoPP) and ETCO2, no significant differences between STD and ACD CPR were found. In 3 cases ROSC could be achieved for a short time.


CONCLUSIONS
In our study, a comparison of STD and ACD CPR revealed no significant differences in coronary perfusion pressures and ETCO2. We conclude that after prolonged CA, ACD CPR does not provide an apparent hemodynamic advantage over STD CPR.
Malzer
R
R
Department of Emergency Medicine, General Hospital Vienna, Austria.
Zeiner
A
A
Binder
M
M
Domanovits
H
H
Knappitsch
G
G
Sterz
F
F
Laggner
A N
AN
D000368:Aged; D001775:Blood Circulation; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000378:metabolism*; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation / Q000379:methods*; D002496:Central Venous Pressure; D003326:Coronary Circulation; D004334:Drug Administration Schedule; D004562:Electrocardiography; D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000097:blood; D011312:Pressure; D011446:Prospective Studies; D013990:Tidal Volume
D002245:Carbon Dioxide; D010100:Oxygen; D004837:Epinephrine