Optimizing hemodynamic function during cardiopulmonary resuscitation.
Journal
Current opinion in critical care
ISSN: 1531-7072
Titre abrégé: Curr Opin Crit Care
Pays: United States
ID NLM: 9504454
Informations de publication
Date de publication:
01 06 2021
01 06 2021
Historique:
pubmed:
27
3
2021
medline:
21
5
2021
entrez:
26
3
2021
Statut:
ppublish
Résumé
The purpose of this narrative review is to provide an update on hemodynamics during cardiopulmonary resuscitation (CPR) and to describe emerging therapies to optimize perfusion. Cadaver studies have shown large inter-individual variations in blood distribution and anatomical placement of the heart during chest compressions. Using advanced CT techniques the studies have demonstrated atrial and slight right ventricular compression, but no direct compression of the left ventricle. A hemodynamic-directed CPR strategy may overcome this by allowing individualized hand-placement, drug dosing, and compression rate and depth. Through animal studies and one clinical before-and-after study head-up CPR has shown promising results as a potential strategy to improve cerebral perfusion. Two studies have demonstrated that placement of an endovascular balloon occlusion in the aorta (REBOA) can be performed during ongoing CPR. Modern imaging techniques may help increase our understanding on the mechanism of forward flow during CPR. This could provide new information on how to optimize perfusion. Head-up CPR and the use of REBOA during CPR are novel methods that might improve cerebral perfusion during CPR; both techniques do, however, still await clinical testing.
Identifiants
pubmed: 33769419
doi: 10.1097/MCC.0000000000000819
pii: 00075198-202106000-00003
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
216-222Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Références
Perkins GD, Handley AJ, Koster RW, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation 2015; 95:81–99.
Adnet F, Triba MN, Borron SW, et al. Cardiopulmonary resuscitation duration and survival in out-of-hospital cardiac arrest patients. Resuscitation 2017; 111:74–81.
Guy A, Kawano T, Besserer F, et al. The relationship between no-flow interval and survival with favourable neurological outcome in out-of-hospital cardiac arrest: Implications for outcomes and ECPR eligibility. Resuscitation 2020; 155:219–225.
Georgiou M, Papathanassoglou E, Xanthos T. Systematic review of the mechanisms driving effective blood flow during adult CPR. Resuscitation 2014; 85:1586–1593.
Criley JM. Cough-induced cardiac compression: self-administered form of cardiopulmonary resuscitation. JAMA 1976; 236:1246.
Niemann JT, Rosborough JP, Hausknecht M, et al. Pressure-synchronized cineangiography during experimental cardiopulmonary resuscitation. Circulation 1981; 64:985–991.
Morgan B, Sakamoto N, Shiotani S, Grabherr S.Postmortem computed tomography (pmct) scanning with angiography (pmcta): a description of three distinct methods.Rutty GNEssentials of autopsy practice: advances, updates and emerging technologies.London: Springer London; 2014; 1–21
Iizuka K, Sakamoto N, Shiotani S, et al. Feasibility of resuscitation contrast-enhanced postmortem computed tomography using cardiopulmonary resuscitation technique with chest compression immediately after death. SpringerPlus 2013; 2:663.
Sakamoto N.Postmortem computed tomography angiography using cardiopulmonary resuscitation technique: contrast media injection with chest compression immediately after death.Grabherr S, Grimm JM, Heinemann AAtlas of Postmortem Angiography.Cham: Springer International Publishing; 2016: 121–30
Rutty GN, Robinson C, Amoroso J, et al. Could post-mortem computed tomography angiography inform cardiopulmonary resuscitation research? Resuscitation 2017; 121:34–40.
Hansen K, Machin R, James J, et al. A look inside cardiopulmonary resuscitation: a 4D computed tomography model of simulated closed chest compression. A proof of concept. Resuscitation 2020; 153:149–153.
Koster RW, Beenen LF, van der Boom EB, et al. Safety of mechanical chest compression devices AutoPulse and LUCAS in cardiac arrest: a randomized clinical trial for non-inferiority. Eur Heart J 2017; 38:3006–3013.
Milling L, Mikkelsen S, Astrup BS. Characteristics of mechanical CPR-related injuries: a case series. J Foren Legal Med 2020; 70:101918.
Rutty G, Nolan JP, Soar J. Characteristics of mechanical CPR-related injuries: a case series. J Foren Legal Med 2020; 72:101943.
Skinner DB, Leonard LG, Cooke SAR. Resuscitation following prolonged cardiac arrest. Ann Thorac Surg 1971; 11:201–209.
Wei J, Tung D, Sue SH, et al. Cardiopulmonary resuscitation in prone position: a simplified method for outpatients. J Chin Med Assoc 2006; 69:202–206.
Duhem H, Viglino D, Bellier A, et al. Cadaver models for cardiac arrest: a systematic review and perspectives. Resuscitation 2019; 143:68–76.
Vadeboncoeur T, Stolz U, Panchal A, et al. Chest compression depth and survival in out-of-hospital cardiac arrest. Resuscitation 2014; 85:182–188.
Duval S, Pepe PE, Aufderheide TP, et al. Optimal combination of compression rate and depth during cardiopulmonary resuscitation for functionally favorable survival. JAMA Cardiol 2019; 4:900–908.
Idris AH, Guffey D, Pepe PE, et al. Chest compression rates and survival following out-of-hospital cardiac arrest. Crit Care Med 2015; 43:840–848.
Kovacs A, Vadeboncoeur TF, Stolz U, et al. Chest compression release velocity: association with survival and favorable neurologic outcome after out-of-hospital cardiac arrest. Resuscitation 2015; 92:107–114.
Sutton RM, Friess SH, Maltese MR, et al. Hemodynamic-directed cardiopulmonary resuscitation during in-hospital cardiac arrest. Resuscitation 2014; 85:983–986.
Nestaas S, Stensæth KH, Rosseland V, et al. Radiological assessment of chest compression point and achievable compression depth in cardiac patients. Scand J Trauma Resusc Emerg Med 2016; 24:54.
Hwang SO, Zhao PG, Choi HJ, et al. Compression of the left ventricular outflow tract during cardiopulmonary resuscitation. Acad Emerg Med 2009; 16:928–933.
Paradis NA, Martin GB, Rivers EP, et al. Coronary perfusion pressure and the return of spontaneous circulation in human cardiopulmonary resuscitation. Jama 1990; 263:1106–1113.
Reynolds JC, Salcido DD, Menegazzi JJ. Coronary perfusion pressure and return of spontaneous circulation after prolonged cardiac arrest. Prehosp Emerg Care 2010; 14:78–84.
Kern KB, Ewy GA, Voorhees WD, et al. Myocardial perfusion pressure: A predictor of 24-hour survival during prolonged cardiac arrest in dogs. Resuscitation 1988; 16:241–250.
Morgan RW, French B, Kilbaugh TJ, et al. A quantitative comparison of physiologic indicators of cardiopulmonary resuscitation quality: Diastolic blood pressure versus end-tidal carbon dioxide. Resuscitation 2016; 104:6–11.
Kern KB, Hilwig R, Ewy GA. Retrograde coronary blood flow during cardiopulmonary resuscitation in swine: Intracoronary Doppler evaluation. Am Heart J 1994; 128:490–499.
Kern KB. Coronary perfusion pressure during cardiopulmonary resuscitation. Best Pract Res Clin Anaesthesiol 2000; 14:591–609.
Fries M, Tang W, Chang YT, et al. Microvascular blood flow during cardiopulmonary resuscitation is predictive of outcome. Resuscitation 2006; 71:248–253.
Berg RA, Sutton RM, Reeder RW, et al. Association between diastolic blood pressure during pediatric in-hospital cardiopulmonary resuscitation and survival. Circulation 2017; 137:1784–1795.
Ryu SJ, Lee SJ, Park CH, et al. Arterial pressure, end-tidal carbon dioxide, and central venous oxygen saturation in reflecting compression depth. Acta Anaesthesiol Scand 2016; 60:1012–1023.
Naim M, Sutton RM, Friess SH, et al. Blood pressure and coronary perfusion pressure targeted cardiopulmonary resuscitation improves 24-hour survival from ventricular fibrillation cardiac arrest. Crit Care Med 2016; 44:e1111–e7.
Hamrick JL, Hamrick JT, Lee JK, et al. Efficacy of chest compressions directed by end-tidal CO2 feedback in a pediatric resuscitation model of basic life support. J Am Heart Assoc 2014; 3:1–12.
Lewis LM, Stothert J, Standeven J, et al. Correlation of end-tidal CO2 to cerebral perfusion during CPR. Ann Emerg Med 1992; 21:1131–1134.
Aagaard R, Løfgren B, Caap P, et al. A low end-tidal CO(2)/arterial CO(2) ratio during cardiopulmonary resuscitation suggests pulmonary embolism. Resuscitation 2018; 133:137–140.
Sheak KR, Wiebe DJ, Leary M, et al. Quantitative relationship between end-tidal carbon dioxide and CPR quality during both in-hospital and out-of-hospital cardiac arrest. Resuscitation 2015; 89:149–154.
Tang W, Weil MH, Gazmuri RJ, et al. Pulmonary ventilation/perfusion defects induced by epinephrine during cardiopulmonary resuscitation. Circulation 1991; 84:2101–2107.
Levine RL, Wayne MA, Miller CC. End-tidal carbon dioxide and outcome of out-of-hospital cardiac arrest. N Engl J Med 1997; 337:301–306.
Skulec R, Vojtisek P, Cerny V. Correlation between end-tidal carbon dioxide and the degree of compression of heart cavities measured by transthoracic echocardiography during cardiopulmonary resuscitation for out-of-hospital cardiac arrest. Crit Care 2019; 23:334–1334.
Hamrick JT, Hamrick JL, Bhalala U, et al. End-tidal carbon dioxide–guided chest compression delivery improves survival in a neonatal asphyxial cardiac arrest model. Pediatr Crit Care Med 2017; 18:1–20.
Qvigstad E, Kramer-Johansen J, Tømte Ø, et al. Clinical pilot study of different hand positions during manual chest compressions monitored with capnography. Resuscitation 2013; 84:1203–1207.
Marquez AM, Morgan RW, Ross CE, et al. Physiology-directed cardiopulmonary resuscitation: advances in precision monitoring during cardiac arrest. Curr Opin Crit Care 2018; 24:143–150.
Meaney PA, Bobrow BJ, Mancini ME, et al. Cardiopulmonary resuscitation quality: Improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American heart association. Circulation 2013; 128:417–435.
Friess SH, Sutton RM, French B, et al. Hemodynamic directed CPR improves cerebral perfusion pressure and brain tissue oxygenation. Resuscitation 2014; 85:1298–1303.
Sutton RM, Friess SH, Bhalala U, et al. Hemodynamic directed CPR improves short-term survival from asphyxia-associated cardiac arrest. Resuscitation 2013; 84:696–701.
Babbs CF. We still need a real-time hemodynamic monitor for CPR. Resuscitation 2013; 84:1297–1298.
Morgan RW, Sutton RM, Berg RA. The future of resuscitation: personalized physiology-guided cardiopulmonary resuscitation. Pediatr Crit Care Med 2017; 18:1084–1086.
Wildner G, Pauker N, Archan S, et al. Arterial line in prehospital emergency settings – a feasibility study in four physician-staffed emergency medical systems. Resuscitation 2011; 82:1198–1201.
Sainio M, Hoppu S, Huhtala H, et al. Simultaneous beat-to-beat assessment of arterial blood pressure and quality of cardiopulmonary resuscitation in out-of-hospital and in-hospital settings. Resuscitation 2015; 96:163–169.
Genbrugge C, Eertmans W, Salcido DD. Monitor the quality of cardiopulmonary resuscitation in. Curr Opin Crit Care 2020; 26:219–227.
Moore JC, Holley J, Segal N, et al. Consistent head up cardiopulmonary resuscitation haemodynamics are observed across porcine and human cadaver translational models. Resuscitation 2018; 132:133–139.
Ryu HH, Moore JC, Yannopoulos D, et al. The effect of head up cardiopulmonary resuscitation on cerebral and systemic hemodynamics. Resuscitation 2016; 102:29–34.
Kim T, Shin SD, Song KJ, et al. The effect of resuscitation position on cerebral and coronary perfusion pressure during mechanical cardiopulmonary resuscitation in porcine cardiac arrest model. Resuscitation 2017; 113:101–107.
Putzer G, Braun P, Martini J, et al. Effects of head-up vs. supine CPR on cerebral oxygenation and cerebral metabolism - a prospective, randomized porcine study. Resuscitation 2018; 128:51–55.
Park YJ, Hong KJ, Shin SD, et al. Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model. Clin Exp Emerg Med 2019; 6:250–256.
Debaty G, Shin SD, Metzger A, et al. Tilting for perfusion: head-up position during cardiopulmonary resuscitation improves brain flow in a porcine model of cardiac arrest. Resuscitation 2015; 87:38–43.
Moore JC, Salverda B, Rojas-Salvador C, et al. Controlled sequential elevation of the head and thorax combined with active compression decompression cardiopulmonary resuscitation and an impedance threshold device improves neurological survival in a porcine model of cardiac arrest. Resuscitation 2021; 158:220–227.
Moore JC, Segal N, Lick MC, et al. Head and thorax elevation during active compression decompression cardiopulmonary resuscitation with an impedance threshold device improves cerebral perfusion in a swine model of prolonged cardiac arrest. Resuscitation 2017; 121:195–200.
Debaty G, Moore J, Duhem H, et al. Relationship between hemodynamic parameters and cerebral blood flow during cardiopulmonary resuscitation. Resuscitation 2020; 153:20–27.
Pepe PE, Scheppke KA, Antevy PM, et al. Confirming the clinical safety and feasibility of a bundled methodology to improve cardiopulmonary resuscitation involving a head-up/torso-up chest compression technique. Crit Care Med 2019; 47:449–455.
McGreevy DT, Abu-Zidan FM, Sadeghi M, et al. Feasibility and clinical outcome of Reboa in patients with impending traumatic cardiac arrest. Shock 2020; 54:218–223.
Wasicek PJ, Yang S, Teeter WA, et al. Traumatic cardiac arrest and resuscitative endovascular balloon occlusion of the aorta (REBOA): a preliminary analysis utilizing high fidelity invasive blood pressure recording and videography. Eur J Trauma Emerg Surg 2019; 45:1097–1105.
Brenner M, Teeter W, Hoehn M, et al. Use of resuscitative endovascular balloon occlusion of the aorta for proximal aortic control in patients with severe hemorrhage and arrest. JAMA Surg 2018; 153:130–135.
Tang W, Weil MH, Noc M, et al. Augmented efficacy of external CPR by intermittent occlusion of the ascending aorta. Circulation 1993; 88 (4 Pt 1):1916–1921.
Rubertsson S, Bircher NG, Alexander H. Effects of intra-aortic balloon occlusion on hemodynamics during, and survival after cardiopulmonary resuscitation in dogs. Crit Care Med 1997; 25:1003–1009.
Gedeborg R, Rubertsson S, Wiklund L. Improved haemodynamics and restoration of spontaneous circulation with constant aortic occlusion during experimental cardiopulmonary resuscitation. Resuscitation 1999; 40:171–180.
Phillips SJ, Gordon DF, Iannone L, et al. Clinical trial with a percutaneously inserted intra-aortic balloon pump: a wider spectrum of patient application. Thorac Cardiovasc Surg 1980; 28:197–199.
Deakin CD, Barron DJ. Haemodynamic effects of descending aortic occlusion during cardiopulmonary resuscitation. Resuscitation 1996; 33:49–52.
Coniglio C, Gamberini L, Lupi C, et al. Resuscitative endovascular balloon occlusion of the aorta for refractory out-of-hospital non-traumatic cardiac arrest – a case report. Prehosp Disaster Med 2019; 34:566–568.
Brede JR, Lafrenz T, Kruger AJ, et al. Resuscitative endovascular balloon occlusion of the aorta (REBOA) in non-traumatic out-of-hospital cardiac arrest: evaluation of an educational programme. BMJ Open 2019; 9:e027980.
Brede JR, Lafrenz T, Klepstad P, et al. Feasibility of pre-hospital resuscitative endovascular balloon occlusion of the aorta in non-traumatic out-of-hospital cardiac arrest. J Am Heart Assoc 2019; 8:e014394.
Lamhaut L, Hutin A, Puymirat E, et al. A Pre-Hospital Extracorporeal Cardio Pulmonary Resuscitation (ECPR) strategy for treatment of refractory out hospital cardiac arrest: an observational study and propensity analysis. Resuscitation 2017; 117:109–117.
Lunz D, Calabrò L, Belliato M, et al. Extracorporeal membrane oxygenation for refractory cardiac arrest: a retrospective multicenter study. Intensive Care Med 2020; 46:973–982.