Effects of sustained abdominal aorta compression on coronary perfusion pressures and restoration of spontaneous circulation during cardiopulmonary resuscitation in swine

Objectives

The present study was undertaken to explore whether sustained abdominal aorta compression-cardiopulmonary resuscitation (SAAC-CPR), as a means, can raise coronary perfusion pressure (CPP) as well as restoration of spontaneous circulation (ROSC) during CPR. In the present study, we hypothesised that SAAC-CPR elevates CPP during CPR and improves ROSC, without causing liver laceration.

Methods

Animals were randomised into one of two groups (Standard CPR and SAAC-CPR). Ten domestic swine (22-25 kg) were anaesthetised, intubated and mechanically ventilated. Ventricular fibrillation was induced, and after 3 min of untreated ventricular fibrillation, the animals were treated with standard CPR (with simplex chest compression (SCC) and epinephrine) or SAAC-CPR (SCC with sustained abdominal aorta compression, without epinephrine). CPP and ROSC were compared.

Results

SCC with sustained abdominal aorta compression (SCC + SAAC) significantly increased CPP in comparison with SCC during CPR (p < 0.05). The increase in CPP with SCC + SAAC is equivalent to that achieved with epinephrine (p > 0.05). All animals in the standard CPR and SAAC-CPR groups restored spontaneous circulation. No liver damage was found in post-mortem examinations of the swine subjects.

Conclusions

During CPR, non-invasive SAAC can rapidly and reversibly raise the CPP as much as can epinephrine and is especially suitable for out-of-hospital CPR.