Abstract 91: Aspects on Resuscitation in the Coronary Interventional Catheter Laboratory.
Introduction: Mechanical chest compressions during prolonged cardiac arrest situations, where normal advanced life support efforts fails, using continued percutaneous coronary intervention has been shown feasible and promising.
Hypothesis: Our hypothesis was to show that mechanical chest compressions produce vital physiology during prolonged resuscitation efforts in the cath-lab.
Methods: Sixteen patients suffered cardiac arrest and were treated with mechanical chest compressions (LUCAS 1 V1US, Jolife AB, Sweden) in combination with percutaneous coronary intervention during 11 months period. The following parameters were collected in 10 patients (6 excluded due to computer failure) during the study period: arterial pressures, central venous pressures, coronary perfusion pressure, ETCO2, SpO2 and ECG, enabling us to monitor effects of different resuscitation parameters.
Results: There was increased systolic and mean arterial pressure, during mechanical chest compressions compared to manual chest compressions. Administered adrenaline increased arterial pressure, central venous pressure and coronary perfusion pressure but reduced SpO2 and ETCO2 (Table 1). During different periods of measurements there was a fluctuation in coronary perfusion pressure (n = 4) in a wide range with both low values and values above 15 mmHg in the same patient. We found no direct connection to survival but found survivors with low coronary perfusion pressure some time during the intervention (data will be presented at the conference). Twenty percent of the patients were discharged from hospital in cerebral performance category 1, whereas 30% died in the hospital, following a survival of between 0.5 – 13 days and 50% were declared dead at the cath-lab.
Conclusions: Mechanical chest compressions exert vital physiology during prolonged cardiac arrest in the cath lab and allows for monitoring resuscitation efforts during continued percutaneous coronary intervention.
- © 2010 by American Heart Association, Inc.