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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A survey is given on the scientific background of cardiopulmonary-cerebral resuscitation, which supposedly will be the basis of all clinical practice in this field. Haemodynamic, respiratory, acid-base, and cerebral problems are discussed in detail. As for haemodynamics, the pathomechanisms of the conventional "heart pump" and the "thoracic pump" as background of the "New CPR" are compared, the flow being generated by a direct compression of the heart in the former and by a phasic increase of the intrathoracic pressure in the latter case. Combined effects of both modalities mainly depending on the geometry of the thoracic cage, are usually seen. Improvement of flow by modifying the criteria of thorax compression (duration, frequency, strength) is then discussed, and new methods or CPR as e.g. simultaneous/synchronous compression/respiration, Vest-CPR, MAST-CPR, abdominal compression and Cough-CPR are mentioned and their mechanisms explained. Finally, open cardiac massage is no doubt superior to all the other indirect and closed methods of cardiac resuscitation. Defibrillators and heart-lung "thumpers" are then described, mentioning the improvements in respect of automatic and semi-automatic defibrillation and the progress made by developing flexible and individually adaptable types of "thumpers". On assessing the sympathicomimetic drugs, it is evident that epinephrine is the method of choice in the acute phase of resuscitation; the pure beta-adrenergics isoprenaline and orciprenaline are not used any more, whereas the alpha-mimetics, although acutely effective similar to epinephrine, cannot produce positive long-term effects; the combination of dobutamine and dopamine seems to be ideal for establishing stable haemodynamic situations following a successful acute reanimation procedure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The scientific basis of cardiopulmonary and cerebral resuscitation]. 163 3

The introduction of closed chest massage in 1960 initiated a widespread interest in cardiopulmonary resuscitation. Until that time, open chest cardiac massage was the standard for CPR. Initial explanations for blood flow during closed chest CPR were based upon direct compression of the heart. This explanation has given way to demonstrations that blood flows during CPR because of changes in intrathoracic pressure. Changes in intrathoracic pressure that create blood flow have been created by simple maneuvers such as coughing. More involved methods of affecting intrathoracic pressure, in an attempt to improve upon standard closed chest massage, have included applying positive pressure to the airway, binding of the abdomen, and the use of MAST. Cardiac output with closed chest massage is approximately one fourth of normal, and cerebral perfusion is approximately one tenth of normal. Cardiac output with open chest massage is approximately double that obtained by closed chest massage. Cerebral blood flow during open chest massage approaches physiologic values. The use of drugs possessing alpha adrenergic activity and maneuvers that augment intrathoracic pressure improve vital organ perfusion.
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PMID:Hemodynamics of cardiac massage. 639 69

Whether the cause is primary or secondary, cardiac arrest requires cardiopulmonary resuscitation techniques in order to avoid brain lesions. Cardiac compressions combined with the control of the air passageway and artificial respiration have made it possible to reverse clinical death status in a patient. In this article, the authors review various proven methods including heart pump, thoracic pump, asynchronous respiration, abdominal contrapulsation, cardiopulmonary resuscitation by means of coughing, MAST, ADC, pneumatic vest, etc. which are currently in use.
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PMID:[Cardiopulmonary resuscitation. Support of circulation]. 1051 62