Theoretical advantages of abdominal counterpulsation in CPR as demonstrated in a simple electrical model of the circulation
Recent animal studies and preliminary clinical observations suggest that the addition of interposed abdominal compressions (IAC) to ventilation and chest compression of standard cardiopulmonary resuscitation (CPR) augments blood flow, blood pressures, and immediate survival. To investigate the physi...
Gespeichert in:
Veröffentlicht in: | Annals of emergency medicine 1984-09, Vol.13 (9), p.660-671 |
---|---|
Hauptverfasser: | , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 671 |
---|---|
container_issue | 9 |
container_start_page | 660 |
container_title | Annals of emergency medicine |
container_volume | 13 |
creator | Babbs, Charles F Ralston, Sandra H Geddes, Leslie A |
description | Recent animal studies and preliminary clinical observations suggest that the addition of interposed abdominal compressions (IAC) to ventilation and chest compression of standard cardiopulmonary resuscitation (CPR) augments blood flow, blood pressures, and immediate survival. To investigate the physical basis for enhanced circulation during IAC-CPR, we developed an electrical model of the circulation. Heart and blood vessels were modeled as resistive-capacitive networks, pressures as voltages, blood flow as electric current, blood inertia as inductance, and the cardiac and venous valves as diodes. External pressurization of the heart and great vessels, as would occur in CPR, was simulated by application by half-sinusoidal voltage pulses between vascular capacitances and ground. Closed-chest CPR was simulated by pressurization of all intrathoracic capacitances. IAC was simulated by similar pressurization of the inferior vena cava and abdominal aorta, 180 degrees out of phase with chest compression. During simulation of CPR, IAC improved cranial and myocardial perfusion at all levels of chest compression pressure by amounts linearly related to peak abdominal pressure, suggesting that the abdomen can function as a second, independent blood pump during CPR. Brain and heart flow were improved further during simulated vasoconstriction in kidneys, abdominal viscera, and extremities. Based on the fundamental properties of the cardiovascular system represented in the model, abdominal counterpulsation provides a rational basis for flow augmentation during CPR. |
doi_str_mv | 10.1016/S0196-0644(84)80722-2 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_81194536</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0196064484807222</els_id><sourcerecordid>81194536</sourcerecordid><originalsourceid>FETCH-LOGICAL-c407t-f439aebf2c7892aaeb75c96451e917b49a2f341d97c0fee23f0a77b322bca1283</originalsourceid><addsrcrecordid>eNqFkE2LFDEQhoMo67j6ExZyEj20Jul00jmJDOsHLCi6nkN1Uu1G0p0xSS-If97umWGvQkEVVW-9RT2EXHH2hjOu3n5n3KiGKSlf9fJ1z7QQjXhEdpwZ3Sit2GOye5A8Jc9K-cUYM1LwC3KhpOqU1Dvy9_YOU8YaHEQK_h7mCj-x0DRSGHyawrz2XVrmivmwxAI1pJmGme6_fqNQqMcpzaVmqOi3NtASpkNEihFdzUfbKXmMm2O9Q-pCdks82jwnT0aIBV-c8yX58eH6dv-pufny8fP-_U3jJNO1GWVrAIdRON0bAWupO2eU7DgargdpQIyt5N5ox0ZE0Y4MtB5aIQYHXPTtJXl58j3k9HvBUu0UisMYYca0FNtzbmTXqlXYnYQup1IyjvaQwwT5j-XMbtDtEbrdiNp-jQ26Feve1fnAMkzoH7bOlNf5u9Mc1y_vA2ZbXMDZoQ95pWR9Cv-58A89IZPN</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>81194536</pqid></control><display><type>article</type><title>Theoretical advantages of abdominal counterpulsation in CPR as demonstrated in a simple electrical model of the circulation</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Babbs, Charles F ; Ralston, Sandra H ; Geddes, Leslie A</creator><creatorcontrib>Babbs, Charles F ; Ralston, Sandra H ; Geddes, Leslie A</creatorcontrib><description>Recent animal studies and preliminary clinical observations suggest that the addition of interposed abdominal compressions (IAC) to ventilation and chest compression of standard cardiopulmonary resuscitation (CPR) augments blood flow, blood pressures, and immediate survival. To investigate the physical basis for enhanced circulation during IAC-CPR, we developed an electrical model of the circulation. Heart and blood vessels were modeled as resistive-capacitive networks, pressures as voltages, blood flow as electric current, blood inertia as inductance, and the cardiac and venous valves as diodes. External pressurization of the heart and great vessels, as would occur in CPR, was simulated by application by half-sinusoidal voltage pulses between vascular capacitances and ground. Closed-chest CPR was simulated by pressurization of all intrathoracic capacitances. IAC was simulated by similar pressurization of the inferior vena cava and abdominal aorta, 180 degrees out of phase with chest compression. During simulation of CPR, IAC improved cranial and myocardial perfusion at all levels of chest compression pressure by amounts linearly related to peak abdominal pressure, suggesting that the abdomen can function as a second, independent blood pump during CPR. Brain and heart flow were improved further during simulated vasoconstriction in kidneys, abdominal viscera, and extremities. Based on the fundamental properties of the cardiovascular system represented in the model, abdominal counterpulsation provides a rational basis for flow augmentation during CPR.</description><identifier>ISSN: 0196-0644</identifier><identifier>EISSN: 1097-6760</identifier><identifier>DOI: 10.1016/S0196-0644(84)80722-2</identifier><identifier>PMID: 6465647</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>abdominal counterpulsation, in CPR ; Blood Circulation ; blood flow, in CPR ; CPR, with abdominal counterpulsation ; Electric Stimulation ; Humans ; Male ; Models, Cardiovascular ; Pressure ; Resuscitation ; Vascular Resistance</subject><ispartof>Annals of emergency medicine, 1984-09, Vol.13 (9), p.660-671</ispartof><rights>1984 American College of Emergency Physicians</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-f439aebf2c7892aaeb75c96451e917b49a2f341d97c0fee23f0a77b322bca1283</citedby><cites>FETCH-LOGICAL-c407t-f439aebf2c7892aaeb75c96451e917b49a2f341d97c0fee23f0a77b322bca1283</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0196-0644(84)80722-2$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/6465647$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Babbs, Charles F</creatorcontrib><creatorcontrib>Ralston, Sandra H</creatorcontrib><creatorcontrib>Geddes, Leslie A</creatorcontrib><title>Theoretical advantages of abdominal counterpulsation in CPR as demonstrated in a simple electrical model of the circulation</title><title>Annals of emergency medicine</title><addtitle>Ann Emerg Med</addtitle><description>Recent animal studies and preliminary clinical observations suggest that the addition of interposed abdominal compressions (IAC) to ventilation and chest compression of standard cardiopulmonary resuscitation (CPR) augments blood flow, blood pressures, and immediate survival. To investigate the physical basis for enhanced circulation during IAC-CPR, we developed an electrical model of the circulation. Heart and blood vessels were modeled as resistive-capacitive networks, pressures as voltages, blood flow as electric current, blood inertia as inductance, and the cardiac and venous valves as diodes. External pressurization of the heart and great vessels, as would occur in CPR, was simulated by application by half-sinusoidal voltage pulses between vascular capacitances and ground. Closed-chest CPR was simulated by pressurization of all intrathoracic capacitances. IAC was simulated by similar pressurization of the inferior vena cava and abdominal aorta, 180 degrees out of phase with chest compression. During simulation of CPR, IAC improved cranial and myocardial perfusion at all levels of chest compression pressure by amounts linearly related to peak abdominal pressure, suggesting that the abdomen can function as a second, independent blood pump during CPR. Brain and heart flow were improved further during simulated vasoconstriction in kidneys, abdominal viscera, and extremities. Based on the fundamental properties of the cardiovascular system represented in the model, abdominal counterpulsation provides a rational basis for flow augmentation during CPR.</description><subject>abdominal counterpulsation, in CPR</subject><subject>Blood Circulation</subject><subject>blood flow, in CPR</subject><subject>CPR, with abdominal counterpulsation</subject><subject>Electric Stimulation</subject><subject>Humans</subject><subject>Male</subject><subject>Models, Cardiovascular</subject><subject>Pressure</subject><subject>Resuscitation</subject><subject>Vascular Resistance</subject><issn>0196-0644</issn><issn>1097-6760</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1984</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE2LFDEQhoMo67j6ExZyEj20Jul00jmJDOsHLCi6nkN1Uu1G0p0xSS-If97umWGvQkEVVW-9RT2EXHH2hjOu3n5n3KiGKSlf9fJ1z7QQjXhEdpwZ3Sit2GOye5A8Jc9K-cUYM1LwC3KhpOqU1Dvy9_YOU8YaHEQK_h7mCj-x0DRSGHyawrz2XVrmivmwxAI1pJmGme6_fqNQqMcpzaVmqOi3NtASpkNEihFdzUfbKXmMm2O9Q-pCdks82jwnT0aIBV-c8yX58eH6dv-pufny8fP-_U3jJNO1GWVrAIdRON0bAWupO2eU7DgargdpQIyt5N5ox0ZE0Y4MtB5aIQYHXPTtJXl58j3k9HvBUu0UisMYYca0FNtzbmTXqlXYnYQup1IyjvaQwwT5j-XMbtDtEbrdiNp-jQ26Feve1fnAMkzoH7bOlNf5u9Mc1y_vA2ZbXMDZoQ95pWR9Cv-58A89IZPN</recordid><startdate>198409</startdate><enddate>198409</enddate><creator>Babbs, Charles F</creator><creator>Ralston, Sandra H</creator><creator>Geddes, Leslie A</creator><general>Mosby, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>198409</creationdate><title>Theoretical advantages of abdominal counterpulsation in CPR as demonstrated in a simple electrical model of the circulation</title><author>Babbs, Charles F ; Ralston, Sandra H ; Geddes, Leslie A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-f439aebf2c7892aaeb75c96451e917b49a2f341d97c0fee23f0a77b322bca1283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1984</creationdate><topic>abdominal counterpulsation, in CPR</topic><topic>Blood Circulation</topic><topic>blood flow, in CPR</topic><topic>CPR, with abdominal counterpulsation</topic><topic>Electric Stimulation</topic><topic>Humans</topic><topic>Male</topic><topic>Models, Cardiovascular</topic><topic>Pressure</topic><topic>Resuscitation</topic><topic>Vascular Resistance</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Babbs, Charles F</creatorcontrib><creatorcontrib>Ralston, Sandra H</creatorcontrib><creatorcontrib>Geddes, Leslie A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Babbs, Charles F</au><au>Ralston, Sandra H</au><au>Geddes, Leslie A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Theoretical advantages of abdominal counterpulsation in CPR as demonstrated in a simple electrical model of the circulation</atitle><jtitle>Annals of emergency medicine</jtitle><addtitle>Ann Emerg Med</addtitle><date>1984-09</date><risdate>1984</risdate><volume>13</volume><issue>9</issue><spage>660</spage><epage>671</epage><pages>660-671</pages><issn>0196-0644</issn><eissn>1097-6760</eissn><abstract>Recent animal studies and preliminary clinical observations suggest that the addition of interposed abdominal compressions (IAC) to ventilation and chest compression of standard cardiopulmonary resuscitation (CPR) augments blood flow, blood pressures, and immediate survival. To investigate the physical basis for enhanced circulation during IAC-CPR, we developed an electrical model of the circulation. Heart and blood vessels were modeled as resistive-capacitive networks, pressures as voltages, blood flow as electric current, blood inertia as inductance, and the cardiac and venous valves as diodes. External pressurization of the heart and great vessels, as would occur in CPR, was simulated by application by half-sinusoidal voltage pulses between vascular capacitances and ground. Closed-chest CPR was simulated by pressurization of all intrathoracic capacitances. IAC was simulated by similar pressurization of the inferior vena cava and abdominal aorta, 180 degrees out of phase with chest compression. During simulation of CPR, IAC improved cranial and myocardial perfusion at all levels of chest compression pressure by amounts linearly related to peak abdominal pressure, suggesting that the abdomen can function as a second, independent blood pump during CPR. Brain and heart flow were improved further during simulated vasoconstriction in kidneys, abdominal viscera, and extremities. Based on the fundamental properties of the cardiovascular system represented in the model, abdominal counterpulsation provides a rational basis for flow augmentation during CPR.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>6465647</pmid><doi>10.1016/S0196-0644(84)80722-2</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0196-0644 |
ispartof | Annals of emergency medicine, 1984-09, Vol.13 (9), p.660-671 |
issn | 0196-0644 1097-6760 |
language | eng |
recordid | cdi_proquest_miscellaneous_81194536 |
source | MEDLINE; Elsevier ScienceDirect Journals Complete |
subjects | abdominal counterpulsation, in CPR Blood Circulation blood flow, in CPR CPR, with abdominal counterpulsation Electric Stimulation Humans Male Models, Cardiovascular Pressure Resuscitation Vascular Resistance |
title | Theoretical advantages of abdominal counterpulsation in CPR as demonstrated in a simple electrical model of the circulation |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T08%3A30%3A57IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Theoretical%20advantages%20of%20abdominal%20counterpulsation%20in%20CPR%20as%20demonstrated%20in%20a%20simple%20electrical%20model%20of%20the%20circulation&rft.jtitle=Annals%20of%20emergency%20medicine&rft.au=Babbs,%20Charles%20F&rft.date=1984-09&rft.volume=13&rft.issue=9&rft.spage=660&rft.epage=671&rft.pages=660-671&rft.issn=0196-0644&rft.eissn=1097-6760&rft_id=info:doi/10.1016/S0196-0644(84)80722-2&rft_dat=%3Cproquest_cross%3E81194536%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=81194536&rft_id=info:pmid/6465647&rft_els_id=S0196064484807222&rfr_iscdi=true |