Timing positive-pressure ventilation during chest compression: the key to improving the thoracic pump?

2013 ◽  
Vol 4 (1) ◽  
pp. 24-27 ◽  
Author(s):  
Athanasios Chalkias ◽  
Theodoros Xanthos
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Tidal Volume ◽  
Cerebral Perfusion Pressure ◽  
Chest Compression ◽  
Cerebral Perfusion ◽  
Positive Pressure Ventilation ◽  
Venous Return ◽  
Perfusion Pressure ◽  
Ventilation Rate ◽  
Positive Pressure

Given the importance of increased coronary and cerebral perfusion pressure during cardiopulmonary resuscitation, the recommendation of limiting tidal volume and ventilation rate to 10 per minute in order not to inhibit venous return seems to be correct. However, although the resuscitation community believes that positive-pressure ventilation during cardiopulmonary resuscitation is bad for the circulation, proper timing of compression and ventilation may actually improve the circulation.

Age-related effects of compression rate and duration in cardiopulmonary resuscitation

1990 ◽  
Vol 68 (2) ◽  
pp. 554-560 ◽  
Author(s):  
J. M. Dean ◽  
R. C. Koehler ◽  
C. L. Schleien ◽  
I. Berkowitz ◽  
J. R. Michael ◽  
...  
Keyword(s):  
Relaxation Time ◽  
Cardiopulmonary Resuscitation ◽  
Cerebral Perfusion Pressure ◽  
Chest Wall ◽  
Duty Cycle ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Age Groups ◽  
Compression Rate ◽  
Age Related

The effects of various compression rate and duration combinations on chest geometry and cerebral perfusion pressure during cardiopulmonary resuscitation (CPR) were studied in immature swine. Pentobarbital-anesthetized 2- and 8-wk-old piglets received CPR after ventricular fibrillation. At compression rates of 40, 60, 80, 100, 120, and 150/min, duty cycle (compression duration/total cycle time) was increased from 10 to 80% by 10% increments. Mean aortic and sagittal sinus pressures, pulsatile displacement, and deformity of the anterior chest wall were measured. Increasing duty cycle increased cerebral perfusion pressure until chest relaxation time was compromised. Inadequate chest recoil, development of static chest deformation, and limitation of pulsatile chest wall movement occurred in both age groups when relaxation time was very short (150-200 ms in 2-wk-old piglets, 250-300 ms in 8-wk-old piglets). These changes in chest geometry correlated with deterioration of cerebral perfusion pressure only in 8-wk-old piglets. In the younger group, perfusion pressures plateaued but did not deteriorate. These data emphasize the importance of duty cycle in generating cerebral perfusion pressure and indicate that younger animals can tolerate high compression rates except at extremely long duty cycles.

scholarly journals Chest Compression Synchronized Ventilation versus Intermitted Positive Pressure Ventilation during Cardiopulmonary Resuscitation in a Pig Model

PLoS ONE ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. e0127759 ◽  
Author(s):  
Clemens Kill ◽  
Monika Galbas ◽  
Christian Neuhaus ◽  
Oliver Hahn ◽  
Pascal Wallot ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Positive Pressure Ventilation ◽  
Pig Model ◽  
Positive Pressure

EFFECT OF COMPRESSION RATE AND DUTY CYCLE ON CEREBRAL PERFUSION PRESSURE DURING CARDIOPULMONARY RESUSCITATION IN SHINE

1987 ◽  
Vol 67 (3) ◽  
pp. A152-A152
Author(s):  
R. C. Koehler ◽  
J. M. Dean ◽  
C. L. Schleien ◽  
I. Berkowitz ◽  
J. R. Michael ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Cerebral Perfusion Pressure ◽  
Duty Cycle ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Compression Rate

Transcranial Doppler ultrasonography in raised intra-cranial pressure and in intracranial circulatory arrest

1988 ◽  
Vol 68 (5) ◽  
pp. 745-751 ◽  
Author(s):  
Werner Hassler ◽  
Helmuth Steinmetz ◽  
Jan Gawlowski
Keyword(s):  
Intracranial Pressure ◽  
Brain Death ◽  
Intracranial Hypertension ◽  
Cerebral Perfusion Pressure ◽  
Transcranial Doppler ◽  
Cerebral Perfusion ◽  
Doppler Ultrasonography ◽  
Perfusion Pressure ◽  
Circulatory Arrest ◽  
Transcranial Doppler Ultrasonography

✓ Transcranial Doppler ultrasonography was used to monitor 71 patients suffering from intracranial hypertension with subsequent brain death. Among these, 29 patients were also assessed for systemic arterial pressure and epidural intracranial pressure, so that a correlation between cerebral perfusion pressure and the Doppler ultrasonography waveforms could be established. Four-vessel angiography was also performed in 33 patients after clinical brain death. With increasing intracranial pressure, the transcranial Doppler ultrasonography waveforms exhibited different characteristic high-resistance profiles with first low, then zero, and then reversed diastolic flow velocities, depending on the relationship between intracranial pressure and blood pressure (that is, cerebral perfusion pressure). This study shows that transcranial. Doppler ultrasonography may be used to assess the degree of intracranial hypertension. This technique further provides a practicable, noninvasive bedside monitor of therapeutic measures.

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