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Hemodynamics, survival benefits, and complications of interposed abdominal compression during cardiopulmonary
1Division of Cardiology, University of California Los Angeles Medical Center, USA.
Objective:
To review and describe the hemodynamics and mechanisms of benefit of interposed abdominal compression cardiopulmonary resuscitation (IAC-CPR) as well as the current complications and survival data with the use of IAC-CPR.
Methods:
Critical review of selected, published English-language studies analyzing IAC-CPR. Overview of hemodynamic effects, complications, and survival data of IAC-CPR vs standard CPR.
Results:
Several investigators have demonstrated improvements in coronary perfusion, carotid and cerebral blood flows, and augmented venous return using IAC-CPR compared with standard CPR. Recently, IAC-CPR has been shown to improve survival from in-hospital cardiac arrest. To date, there has been no increase in complications seen with the use of abdominal compression during CPR.
Recommendations:
IAC-CPR should be considered an adjunct to standard CPR for adult patients experiencing in-hospital cardiac arrest, after an adequate airway has been secured. More research is needed before IAC-CPR can be recommended for out-of-hospital cardiac arrest, for patients who have not been intubated, or for children.