BACKGROUND: The efficacy of cardiopulmonary resuscitation (CPR) is vital for saving lives of victims with sudden cardiac arrest. In 1960, Kuowenhoven and colleagues proposed the method that has become standard for CPR. Despite vast input of resources for public education and training of this procedure, its success rate outside hospitals remains poor to dismal. During CPR, restoration of respiration is as important as circulation. But opening the airway and giving effective mouth-to-mouth respiration is difficult for lay people to learn. Furthermore, most bystanders are reluctant to do mouth-to-mouth respiration because of the risk of infection. Therefore, the general population needs a more simplified CPR method for outpatients. The practice of CPR in the prone position, first proposed by McNeil in 1989, has not been adopted, despite the fact that it meets the desirable requirements of ideal resuscitation: simultaneous restoration of circulation and respiration with a very simple maneuver. METHODS: Part 1 (circulation test): Eleven patients who expired in the intensive care unit (ICU), with arterial lines attached, received standard pre-cordial cardiac massage, and the generated blood pressure (BP) was recorded. They were then turned to the prone position, with the head turned to one side. We compressed the patient's thoracic spine with the same force used in standard CPR (rhythm of approximately 60 per minute each time when the back bounces back), and the BP was also recorded. Part 2 (ventilation test): Ten healthy volunteers (5 doctors and 5 nurses) were enlisted for respiratory assessment during compression on the back. With the nose clipped and spontaneous breathing held, the volunteer's exhaled tidal volume upon compression was measured with a spirometer. RESULTS: Standard external cardiac massage of the cadavers generated BPs of 55 +/- 20/13 +/- 7 mmHg; however, external compression on the back of the cadavers generated higher BP of 79 +/- 20/17 +/- 10 mmHg (p = 0.028, Wilcoxon signed-rank analysis). External compression on the back of the volunteers generated mean tidal volumes of 399 +/- 110 mL. CONCLUSION: Our study revealed that prone CPR provides good respiratory and circulatory support at the same time. It is easy to perform and it may be a good alternative way for bystanders to perform CPR in public surroundings. We recommend that more investigators do further studies on this topic.
BACKGROUND: The efficacy of cardiopulmonary resuscitation (CPR) is vital for saving lives of victims with sudden cardiac arrest. In 1960, Kuowenhoven and colleagues proposed the method that has become standard for CPR. Despite vast input of resources for public education and training of this procedure, its success rate outside hospitals remains poor to dismal. During CPR, restoration of respiration is as important as circulation. But opening the airway and giving effective mouth-to-mouth respiration is difficult for lay people to learn. Furthermore, most bystanders are reluctant to do mouth-to-mouth respiration because of the risk of infection. Therefore, the general population needs a more simplified CPR method for outpatients. The practice of CPR in the prone position, first proposed by McNeil in 1989, has not been adopted, despite the fact that it meets the desirable requirements of ideal resuscitation: simultaneous restoration of circulation and respiration with a very simple maneuver. METHODS: Part 1 (circulation test): Eleven patients who expired in the intensive care unit (ICU), with arterial lines attached, received standard pre-cordial cardiac massage, and the generated blood pressure (BP) was recorded. They were then turned to the prone position, with the head turned to one side. We compressed the patient's thoracic spine with the same force used in standard CPR (rhythm of approximately 60 per minute each time when the back bounces back), and the BP was also recorded. Part 2 (ventilation test): Ten healthy volunteers (5 doctors and 5 nurses) were enlisted for respiratory assessment during compression on the back. With the nose clipped and spontaneous breathing held, the volunteer's exhaled tidal volume upon compression was measured with a spirometer. RESULTS: Standard external cardiac massage of the cadavers generated BPs of 55 +/- 20/13 +/- 7 mmHg; however, external compression on the back of the cadavers generated higher BP of 79 +/- 20/17 +/- 10 mmHg (p = 0.028, Wilcoxon signed-rank analysis). External compression on the back of the volunteers generated mean tidal volumes of 399 +/- 110 mL. CONCLUSION: Our study revealed that prone CPR provides good respiratory and circulatory support at the same time. It is easy to perform and it may be a good alternative way for bystanders to perform CPR in public surroundings. We recommend that more investigators do further studies on this topic.
Authors: Myra H Wyckoff; Eunice M Singletary; Jasmeet Soar; Theresa M Olasveengen; Robert Greif; Helen G Liley; David Zideman; Farhan Bhanji; Lars W Andersen; Suzanne R Avis; Khalid Aziz; Jason C Bendall; David C Berry; Vere Borra; Bernd W Böttiger; Richard Bradley; Janet E Bray; Jan Breckwoldt; Jestin N Carlson; Pascal Cassan; Maaret Castrén; Wei-Tien Chang; Nathan P Charlton; Adam Cheng; Sung Phil Chung; Julie Considine; Daniela T Costa-Nobre; Keith Couper; Katie N Dainty; Peter G Davis; Maria Fernanda de Almeida; Allan R de Caen; Edison F de Paiva; Charles D Deakin; Therese Djärv; Matthew J Douma; Ian R Drennan; Jonathan P Duff; Kathryn J Eastwood; Walid El-Naggar; Jonathan L Epstein; Raffo Escalante; Jorge G Fabres; Joe Fawke; Judith C Finn; Elizabeth E Foglia; Fredrik Folke; Karoline Freeman; Elaine Gilfoyle; Craig A Goolsby; Amy Grove; Ruth Guinsburg; Tetsuo Hatanaka; Mary Fran Hazinski; George S Heriot; Karen G Hirsch; Mathias J Holmberg; Shigeharu Hosono; Ming-Ju Hsieh; Kevin K C Hung; Cindy H Hsu; Takanari Ikeyama; Tetsuya Isayama; Vishal S Kapadia; Mandira Daripa Kawakami; Han-Suk Kim; David A Kloeck; Peter J Kudenchuk; Anthony T Lagina; Kasper G Lauridsen; Eric J Lavonas; Andrew S Lockey; Carolina Malta Hansen; David Markenson; Tasuku Matsuyama; Christopher J D McKinlay; Amin Mehrabian; Raina M Merchant; Daniel Meyran; Peter T Morley; Laurie J Morrison; Kevin J Nation; Michael Nemeth; Robert W Neumar; Tonia Nicholson; Susan Niermeyer; Nikolaos Nikolaou; Chika Nishiyama; Brian J O'Neil; Aaron M Orkin; Osokogu Osemeke; Michael J Parr; Catherine Patocka; Jeffrey L Pellegrino; Gavin D Perkins; Jeffrey M Perlman; Yacov Rabi; Joshua C Reynolds; Giuseppe Ristagno; Charles C Roehr; Tetsuya Sakamoto; Claudio Sandroni; Taylor Sawyer; Georg M Schmölzer; Sebastian Schnaubelt; Federico Semeraro; Markus B Skrifvars; Christopher M Smith; Michael A Smyth; Roger F Soll; Takahiro Sugiura; Sian Taylor-Phillips; Daniele Trevisanuto; Christian Vaillancourt; Tzong-Luen Wang; Gary M Weiner; Michelle Welsford; Jane Wigginton; Jonathan P Wyllie; Joyce Yeung; Jerry P Nolan; Katherine M Berg Journal: Resuscitation Date: 2021-11-11 Impact factor: 5.262
Authors: Matthew J Douma; Ella MacKenzie; Tess Loch; Maria C Tan; Dustin Anderson; Christopher Picard; Lazar Milovanovic; Domhnall O'Dochartaigh; Peter G Brindley Journal: Resuscitation Date: 2020-07-21 Impact factor: 5.262
Authors: M A Rodríguez Yago; I Alcalde Mayayo; R Gómez López; M N Parias Ángel; A Pérez Miranda; M Canals Aracil; E Civantos Fuentes; A Rodríguez Núñez; I Manrique Martínez; J López-Herce Cid; G Zeballos Sarrato; C Calvo Macías; A Hernández-Tejedor Journal: Med Intensiva (Engl Ed) Date: 2020-05-16
Authors: Kobi Ludwin; Lukasz Szarpak; Kurt Ruetzler; Jacek Smereka; Bernd W Böttiger; Milosz Jaguszewski; Krzysztof Jerzy Filipiak Journal: Anesth Analg Date: 2020-09 Impact factor: 6.627