This proposal describes a new and highly effective type of cardiopulmonary resuscitation (CPR) and requests support for hemodynamic studies in animals necessary to pave the way toward early clinical trials. The new technique involves all the steps of present CPR with the simple addition of abdominal compressions, interposed between chest compressions. That is, the abdomen is compressed only during the release phase of chest compression. In preliminary studies we have found this new technique, named IAC-CPR for interposed abdominal compression, to improve artificial cardiac output during ventricular fibrillation 2 to 3-fold compared to standard CPR. Blood pressures during IAC-CPR have were 30-150 systolic/20-50 diastolic. The technique is a potential improvement in Basic Life Support, easily performed under field conditions by 2 or 3 rescuers with no equipment other than their bare hands. The principal investigator, who has been awarded an RCDA to study CPR hemodynamics, seeks support for statistically significant animal studies of cardiac output, carotid artery blood flow, and regional blood flow to vital organs during ventricular fibrillation with IAC-CPR as compared to standard CPR. In addition funds are sought to optimize the site, force, area, and timing of interposed abdominal compression in animals and to investigate hypotheses concerning the mechanism of flow enhancement.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
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Surgery and Bioengineering Study Section (SB)
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Purdue University
West Lafayette
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Kern, K B; Sanders, A B; Janas, W et al. (1991) Limitations of open-chest cardiac massage after prolonged, untreated cardiac arrest in dogs. Ann Emerg Med 20:761-7
Kern, K B; Garewal, H S; Sanders, A B et al. (1990) Depletion of myocardial adenosine triphosphate during prolonged untreated ventricular fibrillation: effect on defibrillation success. Resuscitation 20:221-9
Kern, K B; Elchisak, M A; Sanders, A B et al. (1989) Plasma catecholamines and resuscitation from prolonged cardiac arrest. Crit Care Med 17:786-91
Kern, K B; Sanders, A B; Voorhees, W D et al. (1989) Changes in expired end-tidal carbon dioxide during cardiopulmonary resuscitation in dogs: a prognostic guide for resuscitation efforts. J Am Coll Cardiol 13:1184-9
Babbs, C F (1988) The post treatment experiment: an operational definition of reperfusion injury. Basic Life Sci 49:875-9
Babbs, C F (1987) Hemodynamic mechanisms in CPR: a theoretical rationale for resuscitative thoracotomy in non-traumatic cardiac arrest. Resuscitation 15:37-50
Kern, K B; Carter, A B; Showen, R L et al. (1987) Comparison of mechanical techniques of cardiopulmonary resuscitation: survival and neurologic outcome in dogs. Am J Emerg Med 5:190-5
Badylak, S F; Simmons, A; Turek, J et al. (1987) Protection from reperfusion injury in the isolated rat heart by postischaemic deferoxamine and oxypurinol administration. Cardiovasc Res 21:500-6
Kern, K B; Sanders, A B; Badylak, S F et al. (1987) Long-term survival with open-chest cardiac massage after ineffective closed-chest compression in a canine preparation. Circulation 75:498-503
Babbs, C F; Gale, M J (1987) Colorimetric assay for methanesulfinic acid in biological samples. Anal Biochem 163:67-73

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