Abstract P17: Abdominal Compression Achieves Similar Survival Rates to Standard Chest Compression Cardiopulmonary Resuscitation
Objectives: Abdominal compression (AC) cardiopulmonary resuscitation (CPR) is a technique in which blood flow during cardiac arrest is produced by compression of the abdominal wall. The aim of the present study was to assess whether AC-CPR would achieve similar survival rates compared to closed chest compression CPR.
Methods: Fifty piglets were anesthetized, intubated and instrumented. Ventricular fibrillation (VF) was electrically induced and left untreated for 6 minutes before attempted resuscitation, with compressions, ventilation (FiO2=21%) and defibrillation. Animals were randomized into 2 groups (n=25). Group A was resuscitated using chest compression CPR and Group B was resuscitated using AC-CPR. All compressions were delivered with a mechanical compressor (LUCAS) at a rate of 100/min. The recommended advanced life support algorithm was employed. The animals were monitored 4 hours post-resuscitation (PR) and survival was assessed 48 hours after successful resuscitation.
Findings: Fifteen animals in Group A restored spontaneous circulation (6 animals after the 1st defibrillation attempt, 6 animals after the 2nd and 3 animals after the 3rd) in comparison to 14 in Group B (3 animals after the 1st defibrillation, 8 after the 2nd and 3 after the 3rd). During CPR, coronary perfusion pressure (CPP) did not exhibit any statistical difference in the first CPR cycle. This contrasted the 2nd and 3rd CPR cycle where a tendency for higher CPP values was observed in Group A, with no statistical significance. Troponin I remained significantly lower in Group B [1 hour PR, Group A: 8.7±2.4 ng/ml, Group B: 7.9±2.6 ng/ml; 2 hours PR, Group A: 27.4±6.3 ng/ml, Group B: 14.7±3.5 ng/ml (p<0.05); 4 hours PR, Group A: 43.7±3.9 ng/ml, Group B: 28.6±6.2 ng/ml (p<0.05)]. Arterial blood lactate was indistinguishable between the 2 Groups at 1, 2 and 4 hours PR. Ten animals survived in each Group. Post-mortem examination did not reveal any thoracic or visceral traumatic injury related to CPR.
Conclusions: AC-CPR can achieve similar survival rates compared to closed chest compression CPR. Further investigation is necessary to confirm these preliminary results.