Cardiopulmonary Resuscitation with Simultaneous Chest and Abdominal Compression: Comparative Study in Humans

Barranco F, Lesmes A, Irles Ja, et al Resuscitation 1992 Vol 20 Pages 67-77

To assess the efficacy of the simultaneous application of chest and abdominal compression (SCAC) in CPR, the authors performed a prospective study on 18 patients shortly after cardiac arrest. The 14 men and 4 women, ranging from 46-86 years of age, were ICU patients who fulfilled the criteria for brain death. The protocol was initiated 2 minutes after cessation of aortic pressure and the patient had been pronounced dead. Three different CPR techniques were carried out consecutively for five minute segments: 1) Standard CPR utilizing a Michigan Instruments "Thumper", 2) CPR interposed with abdominal compression (IAC-CPR), and 3) SCAC-CPR. Standard CPR was repeated at the end of each sequence. Thoracic aortic and right atrial pressures were recorded and no vasoactive drugs were administered Systolic aortic pressures were 39.02 +/- 21 mmHg, 63.6 +/- 21 mmHg and 94.04 +/- 21 mmHg during standard CPR, IAC-CPR and SCAC-CPR respectively (P<0.001). There was no evidence of intra-abdominal injury in the eight autopsies performed. The authors reach the conclusion that the use of SCAC-CPR on humans does produce greater intravascular pressure and recommend the technique as a possible alternative to standard CPR. Further experimental and clinical studies should be performed before assuming the effectiveness of SCAC-CPR in changing outcome from cardiac arrest.