Cardiopulmonary Resuscitation In Prone Position Research Articles

Changing resuscitation strategies during a pandemic: lessons from the consecutive surges in New York and global challenges.

To provide a framework for resuscitation of COVID-19 critical illness for emergency and intensive care clinicians with the most up to date evidence and recommendations in the care of COVID-19 patients in cardiac arrest or in extremis. Performing cardiopulmonary resuscitation (CPR) on COVID-19 patients requires the clinicians to adopt infection mitigation strategies such as full personal protective equipment, mechanical chest compression devices, and restricting the number of people present during the resuscitation. The time of intubation is a subject of ongoing research and clinicians should use their best judgment for each patient. Clinicians should prepare for CPR in prone position. Particular attention should be given to the psychological well-being of the staff. Point of care ultrasound has proved to be an invaluable diagnostic tool in assessing ventricular dysfunction and parenchymal lung disease. Although novel therapies to supplant the function of diseased lungs have shown promise in select patients the evidence is still being collected. The end-of-life discussions have been negatively impacted by prognostic uncertainty as well as barriers to in person meetings with families. The resuscitation of critically ill COVID-19 patients poses new challenges, but the principles remain largely unchanged.

Cardiopulmonary Resuscitation in Prone Position

Mechanical ventilation in prone position is an alternative strategy for patients with acute respiratory discomfort syndrome (ARDS) to improve oxygenation in situations when traditional ventilation modalities have failed. However, due to the significant increase in ARDS cases during the SARS-CoV-2 pandemic and the experimental therapeutic use of potentially arrhythmogenic drugs, cardiopulmonary resuscitation in this unusual position could be needed. Therefore, we will review the available scientific evidence of cardiopulmonary resuscitation in prone position. Cardiopulmonary Resuscitation in Prone Position

Cardiopulmonary resuscitation in prone position and COVID-19

Received: 9 August, 2020 Accepted: 18 August, 2020 Online first: 22 October, 2020 cardiopulmonary resuscitation (CPR) maneuvers in prone position are recommended (inverted CPR) (5);this technique was described in 1989 by McNeil, and has proven to be successful (6,7) doing the inverse precordial compressions at the usual rate and amplitude Reverse CPR: a pilot study of CPR in the prone position (2) A study conducted in Wuhan, China, reported that 17 9 % of the patients experienced intrahospital cardiac arrest;the arrest rhythms were asystole (89 7 %), pulseless electrical activity (4 4 %) and defibrillatable rhythms (5 9 %) [Extracted from the article] Copyright of Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiologia is the property of Sociedad Colombiana de Anestesiologia y Reanimacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Cardiopulmonary Resuscitation in Prone Position: A Simplified Method for Outpatients

The efficacy of cardiopulmonary resuscitation (CPR) is vital for saving lives of victims with sudden cardiac arrest. In 1960, Kuowenhoven and colleagues proposed the method that has become standard for CPR. Despite vast input of resources for public education and training of this procedure, its success rate outside hospitals remains poor to dismal. During CPR, restoration of respiration is as important as circulation. But opening the airway and giving effective mouth-to-mouth respiration is difficult for lay people to learn. Furthermore, most bystanders are reluctant to do mouth-to-mouth respiration because of the risk of infection. Therefore, the general population needs a more simplified CPR method for outpatients. The practice of CPR in the prone position, first proposed by McNeil in 1989, has not been adopted, despite the fact that it meets the desirable requirements of ideal resuscitation: simultaneous restoration of circulation and respiration with a very simple maneuver. Part 1 (circulation test): Eleven patients who expired in the intensive care unit (ICU), with arterial lines attached, received standard pre-cordial cardiac massage, and the generated blood pressure (BP) was recorded. They were then turned to the prone position, with the head turned to one side. We compressed the patient's thoracic spine with the same force used in standard CPR (rhythm of approximately 60 per minute each time when the back bounces back), and the BP was also recorded. Part 2 (ventilation test): Ten healthy volunteers (5 doctors and 5 nurses) were enlisted for respiratory assessment during compression on the back. With the nose clipped and spontaneous breathing held, the volunteer's exhaled tidal volume upon compression was measured with a spirometer. Standard external cardiac massage of the cadavers generated BPs of 55 +/- 20/13 +/- 7 mmHg; however, external compression on the back of the cadavers generated higher BP of 79 +/- 20/17 +/- 10 mmHg (p = 0.028, Wilcoxon signed-rank analysis). External compression on the back of the volunteers generated mean tidal volumes of 399 +/- 110 mL. Our study revealed that prone CPR provides good respiratory and circulatory support at the same time. It is easy to perform and it may be a good alternative way for bystanders to perform CPR in public surroundings. We recommend that more investigators do further studies on this topic.