Abstract 14511: Are Chest Compressions Effective if Performed in an Adult in the Lateral Position?
Conventional cardiopulmonary resuscitation is performed in the supine position and has been proven effective. However, it is unknown if chest compressions performed in an adult in the lateral position (CCILP) are effective. CCILP may possess advantages, including maintaining better airway patency and potentially minimizing aspiration. However, it is extremely challenging to determine its effectiveness, as the need for it is unpredictable. Therefore, a case study could bring critical insightfulness. Here we report such a case. A 67 year old man with Wolf-Parkinson White syndrome underwent an open left nephrectomy. Intra-operatively, he developed a non-perfusing wide-complex tachycardia with systolic arterial blood pressure (ABP) of less than 20mmHg. CCILP was initiated in the right lateral decubitus position. ABP tracing showed a systolic pressure of about 60mmHg. The patient regained his baseline rhythm after 5 minutes, before cardioversion was conducted. End tidal CO2 level, inspiratory and expiratory O2 concentrations and pulse oxymetry were continuously measured immediately prior to, during and post resuscitation. Ventilator settings were kept constant, and minute O2 absorption and CO2 removal were calculated (Figure 1). Since minute alveolar ventilation was constant, the O2 absorption and CO2 removal were proportional to the cardiac output. The estimated cardiac output generated by CCILP was between 40% (using O2 absorption) to 62.5% (using CO2 removal) in this victim. It seems that CCILP was effective for at least 5 minutes. Formal study is needed to test if effective CCILP can be achieved and if it influences outcome.
- © 2012 by American Heart Association, Inc.