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Title: Coronary blood flow during cardiopulmonary resuscitation in swine

Recent papers have raised doubt as to the magnitude of coronary blood flow during closed-chest cardiopulmonary resuscitation. We will describe experiments that concern the methods of coronary flow measurement during cardiopulmonary resuscitation. Nine anesthetized swine were instrumented to allow simultaneous measurements of coronary blood flow by both electromagnetic cuff flow probes and by the radiomicrosphere technique. Cardiac arrest was caused by electrical fibrillation and closed-chest massage was performed by a Thumper (Dixie Medical Inc., Houston). The chest was compressed transversely at a rate of 66 strokes/min. Compression occupied one-half of the massage cycle. Three different Thumper piston strokes were studied: 1.5, 2, and 2.5 inches. Mean aortic pressure and total systemic blood flow measured by the radiomicrosphere technique increased as Thumper piston stroke was lengthened (mean +/- SD): 1.5 inch stroke, 23 +/- 4 mm Hg, 525 +/- 195 ml/min; 2 inch stroke, 33 +/- 5 mm Hg, 692 +/- 202 ml/min; 2.5 inch stroke, 40 +/- 6 mm Hg, 817 +/- 321 ml/min. Both methods of coronary flow measurement (electromagnetic (EMF) and radiomicrosphere (RMS)) gave similar results in technically successful preparations (data expressed as percent prearrest flow mean +/- 1 SD): 1.5 inch stroke, EMF 12 +/- 5%, RMSmore » 16 +/- 5%; 2 inch stroke, EMF 30 +/- 6%, RMS 26 +/- 11%; 2.5 inch stroke, EMF 50 +/- 12%, RMS 40 +/- 20%. The phasic coronary flow signal during closed-chest compression indicated that all perfusion occurred during the relaxation phase of the massage cycle. We concluded that coronary blood flow is demonstrable during closed-chest massage, but that the magnitude is unlikely to be more than a fraction of normal.« less
Authors:
; ;
Publication Date:
OSTI Identifier:
6749523
Resource Type:
Journal Article
Resource Relation:
Journal Name: Circulation; (United States); Journal Volume: 69:1
Research Org:
Letterman Army Inst. of Research, Presidio of San Francisco, CA
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BLOOD VESSELS; MEASURING METHODS; RADIOISOTOPE SCANNING; CARDIOPULMONARY RESUSCITATION; BLOOD FLOW; ELECTROMAGNETIC TESTING; MICROSPHERES; SWINE; ANIMALS; BODY; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DOMESTIC ANIMALS; FIRST AID; MAMMALS; MATERIALS TESTING; NONDESTRUCTIVE TESTING; ORGANS; TESTING; THERAPY; VERTEBRATES 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics