Effect of phased chest and abdominal compression-decompression cardiopulmonary resuscitation on myocardial and cerebral blood flow in pigs

OBJECTIVE:This study was designed to assess the effects of a phased chest and abdominal compression-decompression cardiopulmonary resuscitation (CPR) device, Lifestick, vs. standard CPR on vital organ blood flow in a porcine CPR model. DESIGN:Prospective, randomized laboratory investigation using an established porcine model with instrumentation for measurement of hemodynamic variables, vital organ blood flow, blood gases, and return of spontaneous circulation. SETTING:University hospital research laboratory. SUBJECTS:Twelve domestic pigs. INTERVENTIONS:After 4 mins of untreated ventricular fibrillation, either the Lifestick CPR device (n = 6) or standard CPR (n = 6) was started and maintained for an additional interval of 6 mins before attempting defibrillation. MEASUREMENTS AND MAIN RESULTS:During CPR, but before epinephrine, use of the Lifestick CPR device resulted in significantly higher (p < .05) mean (± SD) coronary perfusion pressure (23 ± 9 vs. 10 ± 7 mm Hg), cerebral perfusion pressure (29 ± 11 vs. 18 ± 10 mm Hg), mean arterial pressure (49 ± 10 vs. 36 ± 13 mm Hg), end-tidal carbon dioxide (32 ± 11 vs. 20 ± 7 mm Hg), left ventricular myocardial blood flow (44 ± 19 vs. 19 ± 12 mL·min·100 g), and total cerebral blood flow (29 ± 10 vs. 14 ± 12 mL·min·100 g). After 45 μg/kg epinephrine, hemodynamic and vital organ blood flow variables increased to comparable levels in both groups. CONCLUSIONS:Compared with standard CPR, the Lifestick CPR device increased significantly hemodynamic variables and vital organ blood flow during CPR before epinephrine administration.