Mechanical chest compressions maintain vital physiology during prolonged resuscitation efforts in the cath-lab

Abstract

Purpose of the study: Resuscitation efforts with manual chest compressions over an extended period of time during simultaneous PCI in the cath-lab is often connected with low survival. The use of mechanical chest compression devices in these situations has shown promising effects in aspects of survival and successful PCI-result. Can mechanical chest compressions maintain vital physiology during prolonged resuscitation efforts in the cath-lab and gain the possibility to obtain ROSC and survival in patients with normally low survival rate. Material and methods: Sixteen patients suffered cardiac arrest and were treated with mechanical chest compressions (LUCAS 1 V1 US, Jolife AB Sweden) in combination with percutaneous coronary intervention during 11 months period. The following parameters were collected in 10 patients (6 excluded due to computer failure) during the study period; arterial pressure, central venous pressure, coronary perfusion pressure, ETCO2, SpO2, and ECG, enabling us to monitor effects of different resuscitation parameters. Results: A clear difference between manual chest compressions compared to mechanical chest compressions, regarding systolic and mean arterial pressure was seen. Epinephrine significantly increased arterial pressure, central venous pressure, as well as coronary perfusion pressure, but reduced SpO2 and ETCO2. During the entire resuscitation period the coronary perfusion pressure (n = 4) varied in a wide range (−1–57 mmHg), which not correlated to survival. Fifty percent was discharged alive from cath-lab, of whom 30% died in hospital after 0.5–13 days. Twenty percent was discharged from hospital in CPC 1. Conclusion: Vital physiology during prolonged cardiac arrest can be maintained using mechanical chest compressions and increase survival when combined with percutaneous coronary intervention.