Coronary perfusion pressure during cardiopulmonary resuscitation

Karl B. Kern, James T. Niemann, Stig Steen

Research output: Chapter in Book/Report/Conference proceedingChapter

5 Scopus citations

Abstract

Introduction: The resurgence of resuscitation research in the 1970s and 1980s initially focused on the physiological mechanisms for systemic blood flow during closed chest resuscitation for cardiac arrest. At the same time, the importance of both myocardial and cerebral blood flow during cardiopulmonary resuscitation (CPR) became evident. Using contemporary, state-of-art techniques, investigators found that regional perfusion of vital organs occurs with closed chest compression CPR, but at substantially lower rates than that measured during normal sinus rhythm. Such studies have shown that standard anteroposterior chest compressions can, at best, provide 30% to 40% of normal cerebral blood flow levels. Myocardial blood flow achieved with external chest compressions is often even lower, typically between 10% and 30% of normal. Peripheral perfusion is almost non-existent during CPR. Nevertheless, good CPR efforts can temporarily provide at least some perfusion to the myocardium and cerebrum until more definitive treatment (i.e., defibrillation) can be accomplished. Myocardial perfusion during cardiac arrest can be estimated by measuring “coronary perfusion pressure” during the resuscitation effort. This perfusion pressure gradient correlates well with resultant myocardial blood flow generated with CPR and with the subsequent possibility of successful defibrillation. The critical importance of coronary perfusion pressure during CPR has been confirmed in both laboratory and clinical studies of resuscitation. This part of the chapter focuses on coronary perfusion pressure during CPR: Its generation and impact. Determinants of coronary perfusion pressure during cardiopulmonary resuscitation: AoD pressure during CPR: The importance of anadequate perfusion pressure for resuscitation from cardiac arrest was first noted by Crile and Dolley in 1906.

Original languageEnglish (US)
Title of host publicationCardiac Arrest
Subtitle of host publicationThe Science and Practice of Resuscitation Medicine
PublisherCambridge University Press
Pages369-388
Number of pages20
ISBN (Electronic)9780511544828
ISBN (Print)05218470041, 9780521847001
DOIs
StatePublished - Jan 1 2007

ASJC Scopus subject areas

  • Medicine(all)

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    Kern, K. B., Niemann, J. T., & Steen, S. (2007). Coronary perfusion pressure during cardiopulmonary resuscitation. In Cardiac Arrest: The Science and Practice of Resuscitation Medicine (pp. 369-388). Cambridge University Press. https://doi.org/10.1017/CBO9780511544828.020