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J Korean Soc Emerg Med > Volume 10(2); 1999 > Article
Journal of The Korean Society of Emergency Medicine 1999;10(2): 198-207.
A Device Performing a New Method of Cardiopulmonary Resuscitation: A Preliminary Report
Sung Oh Hwang, Young Sik Kim, Jun Hwi Cho, Jong Cheon Lim, Hyun Kim, Bum Jin Oh, Kang Hyun Lee, Seung Hwan Lee, Jung Han Yoon, Kyung Hoon Choe, Yoon Sun Lee
ABSTRACT
BACKGROUND: There have been many efforts to augment blood flow during cardiopulmonary resuscitation. These efforts have focused on maximizing the effect of cardiac pump or thoracic pump alone. However, considering that the heart is the biggest blood reservoir and increase of intrathoracic pressure can generate blood flow, simultaneous exploitation of both mechanisms may have synergistic effect. We hypothesized that simultaneous chest constriction in addition to sternal compression by standard CPR may have additive hemodynamic effects by preventing deformation of the chest and increase of intrathoracic pressure. METHODS AND
RESULTS:
we built a new mechanical device to perform compression and thoracic constriction simultaneously. The device consists of two main elements. Piston in the center is to depress the sternum. Strap is to constrict the thorax circumferentially. Strap is attached to both sides of the piston. When the piston is pushed down, it depresses the sternum and pulls on the thoracic strap. To detemine sump width to produce optimal hemodynamic effect, we measured hemodynamic parameters with variable widths of sump in two dogs after induction of ventricular fibrillation. Result of the experiment showed that 10 cm wide strap was determined to be most effective. We also determined optimal depth of compression to produce maximal hemodynamic effect with animal experiments using two dogs. Animal experiments showed that the highest aortic pressure could be generated when the sternum was depressed to 5 cm. Cardiopulmonary resuscitation using a new device could generate higher systolic aortic pressure, coronary perfusion pressure and end-tidal carbon dioxide tension in comparison with standard cardiopulmonary resuscitation in a pilot animal Study Using two dogs.
CONCLUSION:
New cardiopulmonary resuscitation method using a mechanical device designed by us could perform sternal compression and simultaneous thoracic constriction, and generate better hemodynamic effects than standard cardiopulmonary resuscitation in pilot animal experiments.
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