Abstract P49: Improved Brain Blood Flow During ACD-CPR, Using a Novel Device for Active Chest Decompression in Swine Model of Cardiac Arrest
Introduction: Current CPR guidelines emphasize on complete chest recoil. Incomplete chest recoil impedes venous return and thus cardiac output. In animals active compression-decompression CPR (ACD-CPR) improves hemodynamics compared with standard CPR (S-CPR). We developed a novel, simple, inexpensive Adhesive Glove Device (AGD) to perform ACD-CPR.
Hypothesis: We hypothesized that ACD-CPR using an Adhesive Glove Device (AGD) provides better brain blood flow in a swine model of cardiac arrest as compared to standard CPR.
Methods: Sixteen anesthetized & ventilated (two months old, 12 kg) farm pigs (Palmetto Research Swine) of either sex were randomized (8/group) after 3 minutes of VF cardiac arrest via direct RV current to receive either S-CPR or AGD-ACD-CPR for 2 minutes by rescuers blinded to data recordings. Compressions delivered at 100/min with C:V ratio of 30:2. AGD consisted of a modified leather glove exposing the fingers and thumb allowing interlocking. A wide Velcro patch was sewn to the palmer aspect of the glove and the counter Velcro patch was adhered to the pig’s chest wall. Carotid blood flow was measured via flowprobe (Transonic Systems Inc) placed around the left carotid artery. Stable-isotope labeled microspheres were injected into the LV before induction of cardiac arrest (as baseline) and then at the initiation of CPR in 12 animals (6/group). Blood and brain cortical tissue was collected per protocol and sent to BioPhysics Assay Laboratory (BioPAL), Inc USA for regional blood flow analysis. Data (mean±SD) was analyzed using unpaired t-test; p-value ≤0.05 was considered statistically significant.
Results: Carotid blood flow was greater with AGD-ACD-CPR. The mean blood flow was 53.2±27.1% (% of baseline blood flow in ml/min) in AGD group vs. 19.1±12.5% in S-CPR group, p=0.006. Microsphere analysis showed increased cortical blood flow with AGD-CPR. Mean flow was 22.4±5.0% (% of baseline blood flow in ml/min/gm) in AGD group vs. 10.2±6.0% in S-CPR group, p=0.003.
Conclusions: Use of our simple inexpensive Adhesive Glove Device (AGD) for chest compression resulted in more than doubled brain blood flow compared to S-CPR as measured by two different techniques.