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(Circulation. 1997;95:1335-1340.)
© 1997 American Heart Association, Inc.

Articles

Phased Chest and Abdominal Compression-Decompression

A New Option for Cardiopulmonary Resuscitation

Wanchun Tang, MD; Max Harry Weil, MD, PhD; Robert B. Schock, PhD; Yoji Sato, MD; John Lucas, ME; Shijie Sun, MD; Joe Bisera, MSEE

the Institute of Critical Care Medicine (W.T., M.H.W., Y.S., S.S., J.B.), Palm Springs, Calif; the University of Southern California School of Medicine (W.T., M.H.W., S.S., J.B.); and the Cardiac Assist Division, Datascope Corp (R.B.S., J.L.), Fairfield, NJ.

Background We describe a new manual method of phased chest and abdominal compression-decompression with a Lifestick resuscitator for cardiopulmonary resuscitation (CPR).

Methods and Results Ventricular fibrillation (VF) was induced in 20 domestic pigs. After either 5 or 7 minutes of untreated VF, either phased chest and abdominal compression-decompression (Lifestick resuscitator) or precordial compression was initiated. Defibrillation was attempted at 2 minutes after the start of CPR. For the animals in which VF was untreated for 7 minutes, epinephrine was administered in doses of 20 µg/kg at 2 minutes after start of CPR. The coronary perfusion pressure generated by the Lifestick resuscitator was more than twofold greater (P<.01) than that generated by conventional precordial compression. Of 5 control animals, none were resuscitated after 5 minutes of VF. However, each of 5 animals treated with the Lifestick resuscitator was resuscitated (P<.01) and survived after 48 hours (P<.01). When untreated VF was prolonged to 7 minutes and epinephrine was administered, only 2 of the 5 control animals were resuscitated, and none of them survived for more than 4 hours. However, each of the Lifestick-treated animals was resuscitated and survived for more than 48 hours (P<.01).

Conclusions Phased chest and abdominal compression-decompression substantially increased hemodynamic efficacy of CPR and outcome in terms of successful resuscitation, 48-hour survival, and cerebral recovery.

Key Words: cardiopulmonary resuscitation • fibrillation • heart arrest • defibrillation • death, sudden

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