Cardiopulmonary resuscitation with a novel chest compression device in a porcine model of cardiac arrest: Improved hemodynamics and mechanisms

Henry R Halperin, Norman Paradis, Joseph P. Ornato, Menekhem Zviman, Jennifer LaCorte, Albert Lardo, Karl B. Kern

Research output: Contribution to journalArticle

Abstract

The goal of this study was to determine the magnitude and mechanisms of hemodynamic improvement of an automated, load-distributing band device (AutoPulse, Revivant Corp., Sunnyvale, California) compared with conventional cardiopulmonary resuscitation (C-CPR). Improved blood flow during cardiopulmonary resuscitation (CPR) enhances survival from cardiac arrest. AutoPulse CPR (A-CPR) and C-CPR were performed on 30 pigs (16 ± 4 kg) 1 min after induction of ventricular fibrillation. Aortic and right atrial pressures were measured with micromanometers. Regional flows were measured with microspheres; A-CPR and C-CPR were performed with 20% anterior-posterior chest compression, with (n = 10) and without (n = 10) epinephrine. A pressure transducer was advanced down the airways during chest compressions (n = 10), and magnetic resonance imaging (MRI) was performed. AutoPulse CPR improved coronary perfusion pressure (CPP) (aortic - right atrial pressure) without epinephrine (A-CPR 21 ± 8 mm Hg vs. C-CPR 14 ± 6 mm Hg, mean ± SD, p <0.0001) and with epinephrine (A-CPR 45 ± 11 mm Hg vs. C-CPR 17 ± 6 mm Hg, p <0.0001). AutoPulse CPR improved myocardial flow without epinephrine and cerebral and myocardial flow with epinephrine (p <0.05). AutoPulse CPR also produced greater myocardial flow at every CPP (p <0.01). With A-CPR, high airway pressure was noted distal to the carina, which corresponded to an area of airway collapse on MRI, and which was not present with C-CPR. AutoPulse CPR improved hemodynamics over C-CPR in this pig model. AutoPulse CPR with epinephrine can produce pre-arrest levels of myocardial and cerebral flow. The improved hemodynamics with A-CPR appear to be mediated through airway collapse, which likely impedes airflow and helps maintain higher levels of intrathoracic pressure.

Original languageEnglish (US)
Pages (from-to)2214-2220
Number of pages7
JournalJournal of the American College of Cardiology
Volume44
Issue number11
DOIs
StatePublished - Dec 7 2004

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Cardiopulmonary Resuscitation
Heart Arrest
Swine
Thorax
Hemodynamics
Equipment and Supplies
Epinephrine
Atrial Pressure
Pressure
Perfusion
Magnetic Resonance Imaging
Pressure Transducers
Ventricular Fibrillation

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Cardiopulmonary resuscitation with a novel chest compression device in a porcine model of cardiac arrest : Improved hemodynamics and mechanisms. / Halperin, Henry R; Paradis, Norman; Ornato, Joseph P.; Zviman, Menekhem; LaCorte, Jennifer; Lardo, Albert; Kern, Karl B.

In: Journal of the American College of Cardiology, Vol. 44, No. 11, 07.12.2004, p. 2214-2220.

Research output: Contribution to journalArticle

Halperin, Henry R ; Paradis, Norman ; Ornato, Joseph P. ; Zviman, Menekhem ; LaCorte, Jennifer ; Lardo, Albert ; Kern, Karl B. / Cardiopulmonary resuscitation with a novel chest compression device in a porcine model of cardiac arrest : Improved hemodynamics and mechanisms. In: Journal of the American College of Cardiology. 2004 ; Vol. 44, No. 11. pp. 2214-2220.
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AU - Kern, Karl B.

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