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(Circulation. 1999;100:2146.)
© 1999 American Heart Association, Inc.

Clinical Investigation and Reports

CPR Techniques That Combine Chest and Abdominal Compression and Decompression

Hemodynamic Insights From a Spreadsheet Model

Charles F. Babbs, MD, PhD

From Indiana University School of Medicine and the Department of Basic Medical Sciences, Purdue University, West Lafayette, Ind.

Correspondence to Charles F. Babbs, MD, PhD, Basic Medical Sciences, 1246 Lynn Hall, Purdue University, West Lafayette, IN 47907-1246. E-mail babbs{at}vet.purdue.edu

Background—This study was done to elucidate mechanisms by which newer cardiopulmonary resuscitation (CPR) techniques, including interposed abdominal compression (IAC), active compression-decompression (ACD), and Lifestick CPR, augment systemic perfusion pressure and forward flow and to compare the 3 techniques in the same test system.

Methods and Results—Mathematical models describing hemodynamics of the adult human circulation during cardiac arrest and CPR were created and exercised by use of spreadsheet software. Assumptions of the models are limited to normal human anatomy and physiology, the definition of compliance (volume change/pressure change), and Ohm’s law (flow=pressure/resistance). Standard CPR generates 1.3 L/min forward and 25 mm Hg systemic perfusion pressure. In otherwise identical models, IAC-CPR generates 2.4 L/min and 45 mm Hg; ACD-CPR, 1.6 L/min and 30 mm Hg; and Lifestick CPR, which combines IAC and ACD, 3.1 L/min and 58 mm Hg. Augmented CPR techniques work by enhanced priming of either chest or abdominal pump mechanisms.

Conclusions—Adjunctive maneuvers, combined with conventional chest compression, can produce substantial hemodynamic benefit in CPR by credible physiological mechanisms.

Key Words: blood flow • cardiopulmonary resuscitation • computers • heart arrest • Lifestick • mechanics

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