American Heart Journal
Volume 156, Issue 6 , Pages 1222.e1-1222.e7 , December 2008

Direction of blood flow from the left ventricle during cardiopulmonary resuscitation in humans—its implications for mechanism of blood flow

  • Hyun Kim, MD

      Affiliations

    • Department of Emergency Medicine, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
  • ,
  • Sung Oh Hwang, MD

      Affiliations

    • Department of Emergency Medicine, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
    • Corresponding Author InformationReprint requests: Sung Oh Hwang, MD, Department of Emergency Medicine, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, 162 Ilsandong, Wonju 220-701, South Korea.
  • ,
  • Christopher C. Lee, MD

      Affiliations

    • Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
  • ,
  • Kang Hyun Lee, MD

      Affiliations

    • Department of Emergency Medicine, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
  • ,
  • Jang Young Kim, MD

      Affiliations

    • Department of Cardiology, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
  • ,
  • Byung Su Yoo, MD

      Affiliations

    • Department of Cardiology, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
  • ,
  • Seung Hwan Lee, MD

      Affiliations

    • Department of Cardiology, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
  • ,
  • Jung Han Yoon, MD

      Affiliations

    • Department of Cardiology, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
  • ,
  • Kyung Hoon Choe, MD

      Affiliations

    • Department of Cardiology, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
  • ,
  • Adam J. Singer, MD

      Affiliations

    • Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY

Received 3 April 2008 ,Accepted 8 September 2008.

References 

  1. Barsan WG, Levy RC. Experimental design for study of cardiopulmonary resuscitation in dogs. Ann Emerg Med. 1981;10:135–137
  2. Rubertsson S, Grenvik A, Zemgulis V. Systemic perfusion pressure and blood flow before and after administration of epinephrine during experimental cardiopulmonary resuscitation. Crit Care Med. 1995;23:1984–1996
  3. Fitzgerald KR, Babbs CF, Frissora HA, et al. Cardiac output during cardiopulmonary resuscitation at various compression rates and durations. Am J Physiol. 1981;H442–H448
  4. Voorhees WD, Babbs CF, Tacker WA. Regional blood flow during cardiopulmonary resuscitation in dogs. Crit Care Med. 1980;8:134–136
  5. Beattie C, Guerci AD, Hall T, et al. Mechanisms of blood flow during pneumatic vest cardiopulmonary resuscitation. J Appl Physiol. 1991;70:454–465
  6. Criley JM, Nieman JT, Rosborough JP, et al. Modifications of cardiopulmonary resuscitation based on the cough. Circulation. 1986;74(Suppl IV):IV-42–IV-50
  7. Guerci AD, Halperin HR, Beyar R, et al. Aortic diameter and pressure-flow sequence identify mechanism of blood flow during external chest compression in dogs. J Am Coll Cardiol. 1989;14:790–798
  8. Kuhn C, Juchems R, Frese W. Evidence for the ‘cardiac pump theory’ in cardiopulmonary resuscitation in man by transesophageal echocardiography. Resuscitation. 1991;22:275–282
  9. Maier GW, Newton JR, Wolfe JA, et al. The influence of manual chest compression rate on hemodynamic support during cardiac arrest: high-impulse cardiopulmonary resuscitation. Circulation. 1986;76:IV51–IV59
  10. Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed chest cardiac massage. JAMA. 1960;173:1064–1067
  11. Chandra NC, Tsitlik JE, Halperin HR, et al. Observation of hemodynamics during human cardiopulmonary resuscitation. Crit Care Med. 1990;18:929–934
  12. Nieman JT, Rosborough JP, Hausknecht M, et al. Pressure-synchronized cineangiography during experimental cardiopulmonary resuscitation. Circulation. 1981;64:985–991
  13. Paradis NA, Martin GB, Goetting MG, et al. Simultaneous aortic, jugular bulb, and right atrial pressures during cardiopulmonary resuscitation in humans. Insights into mechanisms. Circulation. 1989;80:361–368
  14. Halperin HR, Guerci AD, Chandra N, et al. Vest inflation without simultaneous ventilation during cardiac arrest in dogs: improved survival from prolonged cardiopulmonary resuscitation. Circulation. 1986;74:1407–1415
  15. American Heart Association . Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. International Consensus on Science. Circulation. 2000;102:I–22-59
  16. Sellers RD, Levy MJ, Amplatz K, et al. Left retrograde cardioangiography in acquired cardiac disease: technique, indications and interpretations in 700 cases. Am J Cardiol. 1964;14:437–447
  17. Schiller NB, Shah PM, Crawford M, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr. 1989;2:358–367
  18. Werner JA, Greene HL, Janko CL, et al. Visualization of cardiac valve motion in man during external chest compression using two-dimensional echocardiography. Implications regarding the mechanism of blood flow. Circulation. 1981;63:1417–1421
  19. Higano ST, Oh JK, Ewy GA, et al. The mechanism of blood flow during closed chest cardiac massage in humans: transesophageal echocardiographic observation. Mayo Clin Proc. 1990;65:1432–1440
  20. Redberg RF, Tucker KJ, Cohen TJ, et al. Physiology of blood flow during cardiopulmonary resuscitation. A transesophageal echocardiographic study. Circulation. 1993;88:534–542
  21. Porter TR, Ornato JP, Guard CS, et al. Transesophageal echocardiography to assess mitral valve function and flow during cardiopulmonary resuscitation. Am J Cardiol. 1992;70:1056–1060
  22. Mair P, Kornberger E, Schwarz B, et al. Forward blood flow during cardiopulmonary resuscitation in patients with severe accidental hypothermia. An echocardiographic study. Acta Anaesthesiol Scand. 1998;42:1139–1144
  23. Halperin HR, Weiss JL, Guerci AD, et al. Cyclic elevation of intrathoracic pressure can close the mitral valve during cardiac arrest in dogs. Circulation. 1988;78:754–760
  24. Maier GW, Tyson GS, Olsen CO, et al. The physiology of external cardiac massage: high-impulse cardiopulmonary resuscitation. Circulation. 1984;70:86–101
  25. Ma MH, Hwang JJ, Lai LP, et al. Transesophageal echocardiographic assessment of mitral valve position and pulmonary venous flow during cardiopulmonary resuscitation in humans. Circulation. 1995;92:854–861
  26. Klouche K, Weil MH, Sun S, et al. Stroke volumes generated by precordial compression during cardiac resuscitation. Crit Care Med. 2002;30:2626–2631
  27. Ornato JP, Levine RL, Young DS, et al. The effect of applied chest compression force on systemic arterial pressure and end-tidal carbon dioxide concentration during CPR in human beings. Ann Emerg Med. 1989;18:732–737
  28. Hillman K, Albin M. Pulmonary barotrauma during cardiopulmonary resuscitation. Crit Care Med. 1986;14:606–609
  29. Klouche K, Weil MH, Sun S, et al. Evolution of the stone heart after prolonged cardiac arrest. Chest. 2002;122:1006–1011
  30. Takino M, Okada Y. Firm myocardium in cardiopulmonary resuscitation. Resuscitation. 1996;33:101–106

PII: S0002-8703(08)00790-4

doi: 10.1016/j.ahj.2008.09.003

American Heart Journal
Volume 156, Issue 6 , Pages 1222.e1-1222.e7 , December 2008