Active compression-decompression CPR improves vital organ perfusion in a dog model of ventricular fibrillation: Chest 1994; 106/4: 1250–1259

Abstract

Objectives This study was designed to assess whether a new method of cardiopulmonary resuscitation (CPR), termed active compression-decompression CPR, or ACD-CPR, improves organ perfusion when compared with standard (S) CPR in a dog model of ventricular fibrillation. Background ACD-CPR has recently been shown to improve hemodynamic and respiratory parameters during cardiac arrest when compared with standard CPR. However, to our knowledge, the effects of ACD-CPR on tissue perfusion have not been investigated. Methods Ventricular fibrillation was induced in eight anesthetized, intubated animals. ACD-CPR and standard CPR were each performed twice in alternating order. All interventions were preceded by 1 min of ventricular fibrillation, in which no CPR was performed, and consisted of 6 min of CPR with either technique during which tissue perfusion was measured. Compressions were performed at 80/min with a 50 percent duty cycle and 175 to 200 N downward force applied to the chest wall for both techniques. Epinephrine was administered at the beginning of each 6-min CPR interval. Hemodynamic monitoring of aortic and right atrial pressure was performed continuously and myocardial, cerebral, and renal blood flows were measured using the radiolabeled microsphere technique at baseline and during all interventions. Results Baseline organ perfusion and hemodynamics were similar for all dogs. Baseline left ventricular, brain, and renal blood flows were 62.0±5.5, 14.1±2.1, and 476.3±55.5 ml/min/100 g, respectively (mean±SEM). Compared with standard CPR, ACD-CPR resulted in higher global left ventricular (22.5±6.2 vs 14.1±4.0 ml/min/100 g, p Conclusions We conclude that ACD-CPR improves tissue perfusion and systemic hemodynamics compared with standard CPR.