Abstract
BackgroundMechanical chest compressions (CCs) have been shown capable of maintaining circulation in humans suffering cardiac arrest for extensive periods of time. Reports have documented a visually normalized coronary blood flow during angiography in such cases (TIMI III flow), but it has never been actually measured. Only indirect measurements of the coronary circulation during cardiac arrest with on-going mechanical CCs have been performed previously through measurement of the coronary perfusion pressure (CPP). In this study our aim was to correlate average peak coronary flow velocity (APV) to CPP during mechanical CCs.MethodsIn a closed chest porcine model, cardiac arrest was established through electrically induced ventricular fibrillation (VF) in eleven pigs. After one minute, mechanical chest compressions were initiated and then maintained for 10 minutes upon which the pigs were defibrillated. Measurements of coronary blood flow in the left anterior descending artery were made at baseline and during VF with a catheter based Doppler flow fire measuring APV. Furthermore measurements of central (thoracic) venous and arterial pressures were also made in order to calculate the theoretical CPP.ResultsAverage peak coronary flow velocity was significantly higher compared to baseline during mechanical chests compressions and this was observed during the entire period of mechanical chest compressions (12 - 39% above baseline). The APV slowly declined during the 10 min period of mechanical chest compressions, but was still higher than baseline at the end of mechanical chest compressions. CPP was simultaneously maintained at > 20 mmHg during the 10 minute episode of cardiac arrest.ConclusionOur study showed good correlation between CPP and APV which was highly significant, during cardiac arrest with on-going mechanical CCs in a closed chest porcine model. In addition APV was even higher during mechanical CCs compared to baseline. Mechanical CCs can, at minimum, re-establish coronary blood flow in non-diseased coronary arteries during cardiac arrest.
Highlights
Mechanical chest compressions (CCs) have been shown capable of maintaining circulation in humans suffering cardiac arrest for extensive periods of time
Mechanical chest compression (CC) devices used during cardiac arrest in the cardiac catheterization laboratory have been shown capable of producing adequate coronary perfusion pressures (CPP) which is well correlated to normal coronary blood flow, Thrombolysis In
We found a significant correlation between CPP and average peak coronary flow velocity (APV) during ventricular fibrillation (VF) with circulation dependent on mechanical CCs
Summary
Mechanical chest compressions (CCs) have been shown capable of maintaining circulation in humans suffering cardiac arrest for extensive periods of time. Reports have documented a visually normalized coronary blood flow during angiography in such cases (TIMI III flow), but it has never been measured. In this study our aim was to correlate average peak coronary flow velocity (APV) to CPP during mechanical CCs. Mechanical chest compression (CC) devices used during cardiac arrest in the cardiac catheterization laboratory (cath-lab) have been shown capable of producing adequate coronary perfusion pressures (CPP) which is well correlated to normal coronary blood flow, Thrombolysis In. Myocardial Infarction-flow (TIMI-flow) III [1]. One study used a cardio pulmonary bypass system to mimic a low flow state and an ultrasonic flow probe inserted in the left anterior descending artery (LAD) in a porcine open chest model [15], this method is well documented
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
