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Opening the Chest to Keep the Brain Alive in Prolonged Cardiopulmonary Resuscitation (CPR)

Published online by Cambridge University Press:  28 June 2012

James K. Alifimoff
Affiliation:
Work performed as students.
Peter Safar
Affiliation:
From the Resuscitation Research Center and Department of Anesthesiology/Critical Care Medicine, University of Pittsburgh, Pittsburgh PA 15260, USA.
Nicholas G. Bircher
Affiliation:
Work performed as students.

Extract

Introduction: Standard closed-chest CPR (SCPR) produces only 6–30% of normal blood flow. It is unlikely that this can sustain the viability of the brain for more than a few minutes in most CPR attempts, although in occasional cases of human resuscitation external CPR for up to two hours has been followed by recovery of consciousness. Thus various methods have been employed to improve this low perfusion state. It has been shown that abdominal compression by hand or MAST-suit can augment carotid artery blood flow during CPR but causes complications. Openchest CPR (OCCPR) has also been proven to be hemodynamically superior to SCPR. Since neurologic recovery has been studied after prolonged periods of total circulatory arrest but not after prolonged periods of CPR, we compared the prolonged use of SCPR and OCCPR in terms of ability to sustain signs of cerebral function during CPR and permit cerebral recovery after CPR.

Type
Part II: Clinical Care Topics
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

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