Cerebral blood flow during cardiopulmonary resuscitation

It is not yet clear which cardiopulmonary resuscitation techniques will result in maximum cerebral blood flow. In addition to the specific techniques of chest compression and ventilation, much information remains to be discovered about the role of osmotic diuretics, lowered Pa(co2), vasoconstrictors to raise arterial pressure, and similar maneuvers on maximizing cerebral blood flow during CPR. The exact recommendations may be different for infants versus adults and for patients with preexisting cerebral edema versus those with normal neurologic states. It is clear, however, that the physiologic relationships between intrathoracic pressure, pleural pressure, venous pressure, intracranial pressure, and cerebral blood flow represented by these investigations into CPR serve as the next steps in modifying current CPR techniques and will result in better neurologic recovery following cardiac arrest.