Abstract
BackgroundDuring cardiopulmonary resuscitation (CPR), chest tubes can hinder increases in intrathoracic pressure by venting the pressure during chest compressions, thus reducing the blood flow generated by the thoracic pump effect. The aim of the present study was to investigate the effects of chest tubes on hemodynamic efficacy during standard CPR in a swine model of cardiac arrest.MethodsTwelve domestic male pigs weighing 39.6 ± 8.4 kg underwent bilateral tube thoracostomy and received a total of 12 min of standard manual CPR, which comprised of two 6-min courses of CPR after 2 min of electrically induced ventricular fibrillation. Each 6-min set consisted of 3 min of CPR with clamped chest tubes (CCT-CPR) and 3 min of CPR with unclamped chest tubes (UCT-CPR). The sequence of CCT-CPR and UCT-CPR was randomized.ResultsHemodynamic parameters including aortic pressure, left ventricular pressure, right ventricular pressure, right atrial pressure, and minimal and maximal dp/dt did not differ significantly between CCT-CPR and UCT-CPR. No significant differences were noted in carotid blood flow, end-tidal CO2, or coronary perfusion pressure between CCT-CPR and UCT-CPR.ConclusionsThe presence of chest tubes did not affect the hemodynamic efficacy of standard CPR. There is no need to clamp chest tubes during standard CPR.
Highlights
During cardiopulmonary resuscitation (CPR), chest tubes can hinder increases in intrathoracic pressure by venting the pressure during chest compressions, reducing the blood flow generated by the thoracic pump effect
There were no significant differences in baseline hemodynamic measurements between the animals allocated to protocol A or B (Table 1)
No significant differences were noted in diastolic hemodynamic parameters including aortic diastolic pressure, left ventricular diastolic pressure, right ventricular diastolic pressure, and right atrial diastolic pressure between CCT-CPR and UCT-CPR
Summary
During cardiopulmonary resuscitation (CPR), chest tubes can hinder increases in intrathoracic pressure by venting the pressure during chest compressions, reducing the blood flow generated by the thoracic pump effect. The cardiac pump theory explains that direct compression of the cardiac structure is the basic mechanism of blood flow generated by chest compressions [2,3,4]. The thoracic pump theory postulates that fluctuations of the intrathoracic pressure, not direct cardiac compressions, cause blood flow by creating a pressure gradient between the intrathoracic and. The presence of chest tubes might alter the mechanism of blood flow generated by chest compressions. Chest tubes might hinder increases in intrathoracic pressure by venting the pleural pressure during chest compressions,
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
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 call
