Effect of interposed abdominal compression during CPR on central arterial and venous pressures

  • John L. McDonald
    Address reprint requests to Dr. McDonald: Emergency Department, Santa Rosa Memorial Hospital, 1165 Montgomery Drive, P.O. Box 2677, Santa Rosa, CA 95405.
    Emergency Department, Santa Rosa Memorial Hospital, Santa Rosa, California, USA.
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      Despite the problems inherent in estimating blood flow from pressure, determination of systolic arterial pressure during cardiopulmonary resuscitation (CPR) is common and probably valuable as an indicator of potential systemic flow. The addition of interposed abdominal compression (IAC) to closed-chest CPR has been promoted because of its potential to increase systolic arterial pressure during CPR. Interposed abdominal compressions have also reportedly increased diastolic arterial-central venous pressure difference (DA-DCVP) and, thus, have the potential to increase coronary vascular flow. Two distinct methods of CPR were studied in conjunction with IAC. In six humans, there was no significant increase late in the resuscitative process in systolic arterial pressure or in DA-DCVP difference with IAC as compared with the two methods of CPR studied without IAC.


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        • Ohomoto T
        • Miura I
        • Konno S
        A new method of external cardiac massage to improve diastolic augmentation and prolonged survival time.
        Ann Thor Surg. 1979; 21: 284-290
        • Ralston SH
        • Babbs CF
        • Niebauer MJ
        Cardiopulmonary resuscitation with interposed abdominal compression in dogs.
        Anesth Analg. 1982; 61: 645-651
        • Ditchey RV
        • Winkler JV
        • Rhodes CA
        Relative lack of coronary blood flow during closed chest resuscitation in dogs.
        Circulation. 1982; 66: 297-302
        • Voorhees WD
        • Neibauer MJ
        • Babbs CF
        Improved oxygen delivery during cardiopulmonary resuscitation with interposed abdominal compression.
        Ann Emerg Med. 1983; 221: 128-135
        • Berryman CR
        • Phillips GM
        Interposed abdominal compression/CPR in human subjects.
        Ann Emerg Med. 1984; 13: 266
        • Chandra N
        • Rudikoff M
        • Tsitlik J
        • et al.
        Augmentation of carotid flow during cardiopulmonary resuscitation in the dog by simultaneous compression and ventilation with high airway pressure.
        Am J Cardiol. 1979; 43: 422
        • Babbs CF
        • Voorhees WD
        • Fitzgerald KR
        • et al.
        Relationship of blood pressure and flow during CPR to chest compression amplitude: Evidence for an effective compression threshold.
        Ann Emerg Med. 1983; 12: 527-532
        • Niemann JT
        • Rosborough JP
        • Ung S
        • et al.
        Coronary perfusion pressure during experimental cardiopulmonary resuscitation.
        Ann Emerg Med. 1982; 11: 127-131
        • Eng C
        • Jentzer JH
        • Kirk ES
        Effects of coronary capacitance on the interpretation of diastolic pressure flow relationships.
        Circ Res. 1982; 50: 334-341
        • Dole WP
        • Bishop VS
        Influence of autoregulation and capacitance on diastolic coronary artery pressure-flow relationships in the dog.
        Circ Res. 1982; 51: 261-270
        • Downey J
        Compression of the coronary arteries by the fibrillating canine heart.
        Circ Res. 1976; 39: 53-57