Abstract 17933: Ultrasound Guided Chest Compressions Over the Left Ventricle During Cardiopulmonary Resuscitation Increases Coronary Perfusion Pressure and Return of Spontaneous Circulation in a Swine Model of Cardiac Arrest
Background: There have been no studies to determine the ideal location of chest compressions during cardiopulmonary resuscitation (CPR), and the standard hand placement is often not directly over the heart; instead, chest compressions are often over the ascending thoracic aorta.
Hypothesis: We hypothesized that chest compressions located over the left ventricle would result in improved coronary perfusion pressure (CPP) or return of spontaneous circulation (ROSC) in a swine model of cardiac arrest.
Methods: Transthoracic echo was used to mark the location of the aortic root and the center of the left ventricle on animals (n=26) which were randomized to receive chest compressions in one of the two locations. After a period of ten minutes of ventricular fibrillation, basic life support (BLS) with mechanical CPR was initiated and performed for ten minutes followed by advanced cardiac life support (ACLS) for an additional ten minutes. During BLS the area of maximal compression was verified using transesophageal echo. CPP was recorded every two minutes.
Results: CPP was higher in the left ventricle group at minutes 24 (p=0.003), 28 (p=0.049), and 30 (p=0.002) which occurred during ACLS. Nine of the left ventricle group (69%) achieved ROSC compared to zero of the aortic root group (p<0.001).
Conclusions: In our swine model, chest compressions performed directly over the left ventricle resulted in an increase in CPP during ACLS and a greater proportion of animals with ROSC.
- © 2013 by American Heart Association, Inc.