Coronary blood flow and perfusion pressure during coronary angiography in patients with ongoing mechanical chest compression: A report on 6 cases☆

Received 28 October 2009; received in revised form 31 January 2010; accepted 2 February 2010.

Abstract

Patients with pulseless electrical activity or refractory ventricular fibrillation have a very bad prognosis. Coronary angiography and angioplasty may be required to restore an effective circulation, but this must be performed whilst chest compressions are continued. The LUCAS chest compression device is suitable for this purpose. So far there are no reports on the effect of this device on coronary circulation in humans. We monitored the coronary perfusion pressure assessed invasively as the difference between the diastolic pressures at the coronary ostium and right atrium, and compared these pressures with coronary flow graded using the TIMI scale in 6 patients. In 4 out of 6 we found a satisfactory coronary artery perfusion pressure and TIMI grade 3 flow (normal) on coronary angiography. Two of these patients survived the first 24h. Two patients did not have a satisfactory perfusion pressure and adequate flow rate was not seen.

Keywords: SCA, PEA, VF, Coronary angiography, PCI, TIMI flow, Coronary blood flow, Coronary perfusion pressure, Mechanical chest compression, LUCAS

a Stavanger University Hospital, Department of Cardiology, Stavanger, Norway

b University of Bergen, Institute of Internal Medicine, Norway

Corresponding author at: University of Bergen, Division of Cardiology, Stavanger University Hospital, N-4001 Stavanger, Norway. Tel.: +47 51518000; fax: +47 51519905.

☆ A Spanish translated version of the abstract of this article appears as Appendix in the final online version at doi:10.1016/j.resuscitation.2010.02.002.

PII: S0300-9572(10)00076-6

doi:10.1016/j.resuscitation.2010.02.002

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