Doppler measurement of cardiac output during cardiopulmonary resuscitation.
OBJECTIVE
To estimate the cardiac output produced by external cardiac compression during standard cardiopulmonary resuscitation performed by two groups of operators with different levels of experience and training.


METHODS
Cardiac output was measured by Doppler aortovelography. All patients included in the study had necropsy examinations. Only patients without evidence of pulmonary embolism, myocardial rupture, aortic valve disease, or acute depletion of the intravascular volume were included.


RESULTS
31 patients presenting to the accident and emergency department suffering from non-traumatic cardiac arrest had cardiac output measurements made during resuscitation. Eleven patients were excluded after necropsy examination. The median cardiac index for the 20 study patients was 3.2 L min-1 m-2. The cardiac output produced by massage by less experienced personnel (median 1.2 L min-1 m-2) was significantly less than that produced by those fully trained in the technique (median 3.2 L min-1 m-2; P < 0.01 95% confidence interval -2.36 to -1.29). The amount of resuscitation related trauma was no greater than in other published series.


CONCLUSIONS
Differences in cardiac output during external cardiac compression are related to experience with the technique.
Fodden
D I
DI
Royal Hallamshire Hospital, Sheffield, United Kingdom.
Crosby
A C
AC
Channer
K S
KS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D002302:Cardiac Output; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000592:standards; D002983:Clinical Competence; D005260:Female; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018608:Ultrasonography, Doppler