The Physiology of Cardiopulmonary Resuscitation
Keith G Lurie1, Edward C Nemergut, Demetris Yannopoulos
1From the Department of Emergency and Internal Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Anesthesiology and Neurological Surgery, University of Virginia, Charlottesville, Virginia; Department of Internal Medicine Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota; and Departments of Anesthesiology and Pediatrics, University of Minnesota, Minneapolis, Minnesota.
Abstract:
Outcomes after cardiac arrest remain poor more than a half a century after closed chest cardiopulmonary resuscitation (CPR) was first described. This review article is focused on recent insights into the physiology of blood flow to the heart and brain during CPR. Over the past 20 years, a greater understanding of heart-brain-lung interactions has resulted in novel resuscitation methods and technologies that significantly improve outcomes from cardiac arrest. This article highlights the importance of attention to CPR quality, recent approaches to regulate intrathoracic pressure to improve cerebral and systemic perfusion, and ongoing research related to the ways to mitigate reperfusion injury during CPR. Taken together, these new approaches in adult and pediatric patients provide an innovative, physiologically based road map to increase survival and quality of life after cardiac arrest.
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