Imaging the human microcirculation during cardiopulmonary resuscitation in a hypothermic victim of submersion trauma.
The microcirculation is essential for delivery of oxygen and nutrients to tissue. However, the human microvascular response to cardiopulmonary resuscitation (CPR) is unknown. We report on the first use of sidestream dark field imaging to assess the human microcirculation during CPR with a mechanical chest compression/decompression device (mCPR). mCPR was able to provide microvascular perfusion. Capillary flow persisted even during brief mCPR interruption. However, indices of microvascular perfusion were low and improved vastly after return of spontaneous circulation. Microvascular perfusion was relatively independent from blood pressure. The microcirculation may be a useful monitor for determining the adequacy of CPR.
Elbers
Paul W G
PW
Department of Anesthesia, Intensive Care and Pain Management, St. Antonius Ziekenhuis, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands. info@acidbase.org
Craenen
Antonius J
AJ
Driessen
Antoine
A
Stehouwer
Marco C
MC
Munsterman
Luuk
L
Prins
Miranda
M
van Iterson
Mat
M
Bruins
Peter
P
Ince
Can
C
D000328:Adult; D016887:Cardiopulmonary Resuscitation; D017809:Fatal Outcome; D006801:Humans; D007035:Hypothermia / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008833:Microcirculation; D008859:Microscopy, Polarization; D015701:Near Drowning / Q000503:physiopathology / Q000628:therapy*; D017694:Rewarming / Q000379:methods*