Rhythmic abdominal compression CPR ventilates without supplemental breaths and provides effective blood circulation

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Standard chest-compression CPR has an out-of-hospital resuscitation rate of less than 10% and can result in rib fractures or mouth-to-mouth transfer of infection. Recently, we introduced a new CPR method that utilizes only rhythmic abdominal compressions (OAC-CPR). The present study compares ventilation and hemodynamics produced by chest and abdominal compression CPR. Twelve swine (29-34kg) were anesthetized, intubated and allowed to breathe spontaneously. Physiologic dead space, resting tidal volume, compression-induced lung air flow, and blood pressures were recorded. Ventricular fibrillation (VF) was electrically induced and subjects were treated with either standard CPR or OAC-CPR at various force and rate settings. Minute alveolar ventilation (MAV) and mean coronary perfusion pressure (CPP) were compared. For OAC-CPR, ventilation per compression tended to increase with increasing force and decreasing rate. Chest only compressions produced no MAV, while OAC-CPR at 80cycles/min or less, matched the MAV for spontaneous respiration. For all rates, abdominal compressions met, or exceeded, the CPP of chest compressions performed at 100lbs. OAC-CPR generated ventilatory volumes significantly greater than the dead space and produced equivalent, or larger, CPP than with chest compressions. Thus, OAC-CPR ventilates a subject, eliminating the need for mouth-to-mouth breathing, and effectively circulates blood during VF without breaking ribs. Furthermore, this technique is simple to perform, can be administered by a single rescuer, and should reduce bystander reluctance to administer CPR.