[Rudolf Eisenmenger's biomotor--predecessor of active compression-decompression cardiopulmonary resuscitation]

Lerman mentioned in 1994 Eisenmenger's Biomotor as a precursor of Active Compression-Decompression Cardiopulmonary Resuscitation (ACD-CPR). We attempted to find additional information. We checked Medline 1966-1998, Quarterly Cumulative Index 1916-1926, Quarterly Cumulative Index Medicus 1927-1950 for publications of Eisenmenger and the secondary literature thereof. Rudolf Eisenmenger (1871-1946) published in 1903 a "Device for Artificial Respiration" consisting of an air-tight thoraco-abdominal shield and a foot-operated bellows for generation of alternating pressure and vacuum on the abdomen and lower thorax. He proposed use of the device for patients in cardiopulmonary arrest caused by drowning or intoxication. The device was patented and in 1904 made commercially available. In 1911 he published a successful resuscitation with his device after one hour of "Vacuum and Pressure Massage of the Abdomen" in a case of attempted suicide by hanging. The foot-operated bellows was replaced by an electromotor (hence "Biomotor") in 1924. Experiments on dogs in cardiac arrest were published in 1929. With the methods available not only "normal" tidal volumes and blood pressure, but also carbon dioxide exhalation and transport of intravenous dye to all parts of the body were shown. In 1939 an eight part series was published, describing use of the device as a respirator in several hospitals. Eisenmenger was the first to propose ACD-CPR, to build a device to perform ACD-CPR and to use it successfully in a patient. Furthermore, he was the first to propose the "cardiac pump theory" and the first to recognize the connection of carbon dioxide exhalation, cardiac output and prognosis of cardiac arrest.