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The effect of applied chest compression force on systemic arterial pressure and endtidal carbon dioxide concentration during CPR in human beings

1989; Elsevier BV; Volume: 18; Issue: 7 Linguagem: Inglês

10.1016/s0196-0644(89)80005-8

1097-6760

Joseph P. Ornato, Ronald L. Levine, Denise S Young, Edward M. Racht, Alexandra Garnett, Edgar R. Gonzalez,

Respiratory Support and Mechanisms

Twelve adult (nine men and three women) cardiac arrest patients were studied as they received CPR by a computerized Thumper® to determine the influence of the applied chest compression force on blood flow (as assessed by the end-tidal carbon dioxide concentration) and arterial pressure. At the end of a resuscitation when the decision was made by the senior physician to cease resuscitative efforts, the applied force on the CPR Thumper® was decreased from 140 to 0 pound-force (lbƒ) in 20-lbƒ increments at 30-second intervals. Radial artery cutdown blood pressure and end-tidal carbon dioxide (ETCO2) were recorded continuously. Arterial stystolic blood pressure was linearly related (r = .59, P < .0001) to applied force (systolic blood pressure, 31 ± 6 mm Hg at 20 lbƒ to 60 ± 7 mm Hg at 140 lbƒ). ETCO2 (r = .42, P < .0001) was also linearly related to applied force (ETCO2, 0.7 ± 0.1% at 20 lbƒ to 1.5 ± 0.2% at 140 lbƒ). Diastolic pressure did not change significantly with change in applied force (17 ± 2 mm Hg from 20 to 140 lbƒ). Our findings indicate that higher compression force than that currently recommended may improve arterial systolic pressure and flow in human beings receiving closed-chest compression during CPR. Twelve adult (nine men and three women) cardiac arrest patients were studied as they received CPR by a computerized Thumper® to determine the influence of the applied chest compression force on blood flow (as assessed by the end-tidal carbon dioxide concentration) and arterial pressure. At the end of a resuscitation when the decision was made by the senior physician to cease resuscitative efforts, the applied force on the CPR Thumper® was decreased from 140 to 0 pound-force (lbƒ) in 20-lbƒ increments at 30-second intervals. Radial artery cutdown blood pressure and end-tidal carbon dioxide (ETCO2) were recorded continuously. Arterial stystolic blood pressure was linearly related (r = .59, P < .0001) to applied force (systolic blood pressure, 31 ± 6 mm Hg at 20 lbƒ to 60 ± 7 mm Hg at 140 lbƒ). ETCO2 (r = .42, P < .0001) was also linearly related to applied force (ETCO2, 0.7 ± 0.1% at 20 lbƒ to 1.5 ± 0.2% at 140 lbƒ). Diastolic pressure did not change significantly with change in applied force (17 ± 2 mm Hg from 20 to 140 lbƒ). Our findings indicate that higher compression force than that currently recommended may improve arterial systolic pressure and flow in human beings receiving closed-chest compression during CPR.