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New Approaches to CPRFour Hands, a Plunger, or a Vest
Henry R. Halperin, MD;
Myron L. Weisfeldt, MD
JAMA. 1992;267(21):2940-2941.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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A major stimulus to improve methods of cardiopulmonary resuscitation (CPR) has come from the realization that blood flow during conventional CPR is marginal, particularly the flow to the heart. To restart the heart, if initial defibrillation fails (or is not possible), coronary flow must be provided.1 With well-performed CPR together with optimal use of epinephrine, brain blood flow probably reaches 30% to 60% of normal; however, myocardial blood flow is much more limited, in the range of 5% to 20% of normal. Repeated studies in animals and important confirmatory studies in man have shown a strong correlation between restarting the heart and higher levels of coronary blood flow.1-3 In animals, coronary flow correlates strongly with the pressure gradient between the aorta and the right atrium. In man, restarting the heart has been shown to correlate with this pressure gradient. A pressure gradient between the aorta and right atrium,
. . . [Full Text PDF of this Article]
Author Affiliations
From the Cardiology Division and the Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Md (Dr Halperin); and the Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY (Dr Weisfeldt). The authors own (with Johns Hopkins) a patent on the inflated vest CPR device.
Footnotes
Reprint requests to Department of Medicine, Columbia-Presbyterian Medical Center, 630 W 168th St, New York, NY 10032-5838 (Dr Weisfeldt).
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