Are you pressing chest right? - bench to bedside
A very interesting article published recently in chest 1 evaluating the quality of chest compressions during CPR (Cardiopulmonary Resuscitation).
Methods: Ventricular fibrillation was induced (by occlusion of the left anterior descending coronary artery) in 24 pigs. Cardiac arrest was left untreated for 5 min. A total of four randomized groups of animals were investigated.
- Animals who receive "conventional" chest compressions first than defibrillation.
- Animals who receive "optimal" chest compressions first than defibrillation.
- Animals who receive defibrillation first than "conventional" chest compressions.
- Animals who receive defibrillation first than "optimal" chest compressions.
Results:
- Coronary perfusion pressures and end-tidal PCO2 were significantly lower with conventional chest compressions.
- With optimal chest compressions, either as an initial intervention or after defibrillation, each animal was successfully resuscitated.
- Fewer shocks were required prior to the return of spontaneous circulation after initial optimal chest compressions.
- No animals were resuscitated when conventional chest compressions preceded the defibrillation attempt.
- When defibrillation was attempted as the initial intervention followed by conventional chest compressions, two of six animals were resuscitated.
Conclusions: In this animal model of cardiac arrest, it was the quality of the chest compressions, rather then the priority of either initial defibrillation or initial chest compressions, that was the predominant determinant of successful resuscitation.
Please refer to full article for Animal Preparation, Measurements, Statistical Analysis, Graphs, Tables and Discussion.
Reference: click to get abstract/article
The Quality of Chest Compressions During Cardiopulmonary Resuscitation Overrides Importance of Timing of Defibrillation - Chest. 2007; 132:70-75
