Abstract 15853: 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 Traumatic Cardiac Arrest
Introduction: Recent evidence has demonstrated that the location of chest compressions during cardiopulmonary resuscitation (CPR) influences coronary perfusion pressure (CPP) and return of spontaneous circulation (ROSC). However, the role of closed chest compressions (CCC) during traumatic cardiac arrest remains controversial, and there currently is no evidence identifying the ideal location for CCC in traumatic arrest.
Hypothesis: We hypothesized that chest compressions located over the left ventricle would result in improved coronary perfusion pressure (CPP) and return of spontaneous circulation (ROSC) in a swine model of traumatic 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. One third of each animal’s blood volume was removed and ventricular fibrillation (VF) was induced to simulate traumatic cardiac arrest. After a period of ten minutes of VF, basic life support (BLS) with mechanical CPR was initiated and performed for ten minutes followed by advanced cardiac life support (ACLS) and blood transfusion 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 during the last four minutes of BLS (p≤0.03) and during the entire ACLS period (p≤0.002). Five of the left ventricle group (38%) achieved ROSC compared to zero of the aortic root group (p=0.04).
Conclusions: In our swine model, chest compressions performed directly over the left ventricle resulted in an increase in CPP during resuscitation and a greater proportion of animals with ROSC.
- Cardiopulmonary resuscitation
- Cardiac arrest
- Coronary circulation
- Return of spontaneous circulation (ROSC)
- Ventricular fibrillation
Author Disclosures: K.L. Anderson: None. M.G. Castaneda: None. S.M. Boudreau: None. K. Cox: None. V.S. Bebarta: None.
- © 2014 by American Heart Association, Inc.