Effects of sustained abdominal aorta compression on coronary perfusion pressures and restoration of spontaneous circulation during cardiopulmonary resuscitation in swine

Abstract

Objectives: The present study was undertaken to explore whether sustained abdominal aorta compression-cardiopulmonary resuscitation (SAAC-CPR), as a means, can raise coronary perfusion pressure (CPP) as well as restoration of spontaneous circulation (ROSC) during CPR. In the present study, we hypothesised that SAAC-CPR elevates CPP during CPR and improves ROSC, without causing liver laceration.

Methods: Animals were randomised into one of two groups (Standard CPR and SAAC-CPR). Ten domestic swine (22-25 kg) were anaesthetised, intubated and mechanically ventilated. Ventricular fibrillation was induced, and after 3 min of untreated ventricular fibrillation, the animals were treated with standard CPR (with simplex chest compression (SCC) and epinephrine) or SAAC-CPR (SCC with sustained abdominal aorta compression, without epinephrine). CPP and ROSC were compared.

Results: SCC with sustained abdominal aorta compression (SCC+SAAC) significantly increased CPP in comparison with SCC during CPR (p<0.05). The increase in CPP with SCC+SAAC is equivalent to that achieved with epinephrine (p>0.05). All animals in the standard CPR and SAAC-CPR groups restored spontaneous circulation. No liver damage was found in post-mortem examinations of the swine subjects.

Conclusions: During CPR, non-invasive SAAC can rapidly and reversibly raise the CPP as much as can epinephrine and is especially suitable for out-of-hospital CPR.