Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-06T04:14:17.323Z Has data issue: false hasContentIssue false

A Comparison of Standard and “New” Cardiopulmonary Resuscitation (CPR) in Dogs

Published online by Cambridge University Press:  28 June 2012

Nicholas G. Bircher
Affiliation:
Work performed as medical student. Supported in part by the Pennsylvania Department of Health and the A. Laerdal Foundation.
Peter Safar
Affiliation:
From the Resuscitation Research Center and Department of Anesthesiology/Critical Care Medicine, University of Pittsburgh, Pittsburgh PA 15260, USA.

Extract

Standard CPR, consisting of 60 chest compressions per min with a ventilation interposed after every fifth compression, often allows restoration of spontaneous circulation but cannot be relied upon to preserve the brain during resuscitation attempts. In experimental models, it produces only one-third to one-half of normal cerebral blood flow and cannot sustain EEG activity. Many attempts have been made to augment overall cardiac output during CPR and presumably thereby increase cerebral blood flow. Crile used a pneumatic pressure suit to bind the abdomen and legs, but subsequent investigations found a high risk of hepatic trauma with abdominal binding. Both Wilder and Harris showed in dogs that simultaneous ventilation and compression augment carotid flow. Birch showed in an animal model that prolonged compression increased mean arterial pressure during CPR. Weisfeldt and colleagues of Baltimore have recently extended these findings to man, and combined them into a so-called “New” CPR, which consists of:

a) high pressure ventilation simultaneous with sternal compression;

b) 40 compressions per min;

c) 60% compression duration; and

d) abdominal binding.

Type
Part II: Clinical Care Topics
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Byrne, D, Pass, HI, Turner, MD et al. External vs. internal cardiac massage in normal and chronically ischemic dogs. Am Surg 1980;46:657.Google Scholar
2. Szmolenszky, T, Szoke, P, Halmagyi, C et al. Organ blood flow during external heart massage. Acta Chir Acad Sci Hung 1971;15:283.Google Scholar
3. Bircher, N, Safar, P, Stewart, R, A comparison of standard “MAST” augmented and open-chest CPR in dogs. Crit Care Med 1980;8:147.CrossRefGoogle ScholarPubMed
4. Crile, GW, reported in Keen, WW. A case of total laryngectomy (unsuccessfull and a case of abdominal hysterectomy (successfull, in both of which massage of the heart for chloroform collapse Misemployed, with notes of 25 other cases of cardiac massage. TherGaz 1904;28:217.Google Scholar
5. Thaler, MM, Krause, VW. Serious trauma in children after external cardiac massage. N Engl J Med 1962;267:500.CrossRefGoogle ScholarPubMed
6. Thaler, MM, Stobie, GHC.. An improved technique of external cardiac compression in infants and young children. N Engl J Med 1963,265:606.CrossRefGoogle Scholar
7. Harris, LC, Kirimll, B, Safar, P, Augmentation of artificial circulation during cardiopulmonary resuscitation. Anesthesiology 1967;28:730.CrossRefGoogle ScholarPubMed
8. Hooper, AC. Complication of experimental external cardiac massage. Irish J Med Sci 1970;3:435.Google ScholarPubMed
9. Alifimoff, JK, Safar, P et al. , Bircher N Cardiac resuscitability after closedchest, MAST-augmentedand open-chest cardiopulmonary resuscitation (CPR). Anesthesiology 1980;53(Supp 1):S151.CrossRefGoogle Scholar
10. Wilder, RJ, Weir, D, Rush, BF et al. Methods of coordinating ventilation and closed-chest cardiac massage in the dog. Surgery 1963;53:186.Google ScholarPubMed
11. Harris, LC, Kirimli, B, Safar, P. Ventilation-cardiac compression ratesand ratios in cardiopulmonary resuscitation. Anesthesiology 1967;28:806.CrossRefGoogle Scholar
12. Birch, LH, Kenney, LJ, Doornbos, F et al. A study of external cardiac compression. J Mich State Med Soc 1962;61:1346.Google ScholarPubMed
13. Rudikoff, MT, Maughan, WL, Effron, Metal. Mechanisms of blood flow during cardiopulmonary resuscitation. Circulation 1980;61:345.CrossRefGoogle ScholarPubMed
14. Chandra, N, Rudikoff, M, Weisfeldt, ML. Simultaneous chest compression and ventilation at high airway pressure during cardiopulmonary resuscitation. Lancet 1980;1:175.CrossRefGoogle ScholarPubMed
15. Downs, JB. A technique for direct measurement of intrapleural pressure. Crit Care Med 1976;4:207.CrossRefGoogle ScholarPubMed
16. Li, CC.. Introduction to Experimental Statistics. New York: McGraw-Hill, 1964.Google Scholar