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 29,987 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

We studied the effect of CPR rate on the hemodynamic indices of surgically instrumented canine experimental models. Using pneumatic vest CPR, we applied simultaneous rib cage and abdominal compressions at rates of 1 to 12 Hz. CPR with 2-Hz frequency yielded the highest aortic and coronary flows (252 +/- 14 and 6.8 +/- 1.1 ml/min vs. 178 + 12 and 0.96 +/- 0.08 ml/min at 1 Hz, respectively; p less than .005). The validity of the present American Heart Association recommendation for 1-Hz CPR rate would benefit from further studies.
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PMID:Effect of vest cardiopulmonary resuscitation rate on cardiac output and coronary blood flow. 275 72

Based upon an anecdotal report of successful resuscitation using a toilet plunger, Cohen and co-workers have developed and investigated a hand-held suction cup as an adjunct to standard manual CPR. This new method, called active compression-decompression cardiopulmonary resuscitation, utilizes a device which is placed over the mid-sternum, approximately 1-2 inches above the lower rib cage border. Active compression-decompression cardiopulmonary resuscitation is then performed in accordance with American Heart Association guidelines at a rate equal to 80-100/min using a 50% duty cycle and compression depth of 1.5-2.0 inches. Initial studies using the ACD device in both models and human subjects late after cardiac arrest have demonstrated improved cardiopulmonary hemodynamics when compared to standard manual CPR. Transophageal echocardiographic studies in human subjects have shown increased left ventricular filling during active decompression suggesting that active chest decompression improves venous return to the heart thus increasing left ventricular volume and stroke volume. Improved resuscitation success has also been documented in human subjects after in-hospital and pre-hospital cardiac arrest. Active compression-decompression cardiopulmonary resuscitation is a simple method which utilizes a hand held suction cup as an interface between rescuer and victim during closed chest circulatory support. This method allows for standard manual cardiopulmonary resuscitation with the addition of active chest wall decompression and appears to be a beneficial adjunct to standard manual cardiopulmonary resuscitation.
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PMID:Clinical and laboratory investigations of active compression-decompression cardiopulmonary resuscitation. 780 80