Resuscitation
Volume 81, Issue 4 , Pages 493-497, April 2010

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

  • Alf Inge Larsen

      Affiliations

    • Stavanger University Hospital, Department of Cardiology, Stavanger, Norway
    • University of Bergen, Institute of Internal Medicine, Norway
    • Corresponding Author InformationCorresponding author at: University of Bergen, Division of Cardiology, Stavanger University Hospital, N-4001 Stavanger, Norway. Tel.: +47 51518000; fax: +47 51519905.
    • ,
  • Åshild Hjørnevik

      Affiliations

    • Stavanger University Hospital, Department of Cardiology, Stavanger, Norway
    • ,
  • Vernon Bonarjee

      Affiliations

    • Stavanger University Hospital, Department of Cardiology, Stavanger, Norway
    • University of Bergen, Institute of Internal Medicine, Norway
    • ,
  • Ståle Barvik

      Affiliations

    • Stavanger University Hospital, Department of Cardiology, Stavanger, Norway
    • ,
  • Tor Melberg

      Affiliations

    • Stavanger University Hospital, Department of Cardiology, Stavanger, Norway
    • University of Bergen, Institute of Internal Medicine, Norway
    • ,
  • Dennis Winston Nilsen

      Affiliations

    • Stavanger University Hospital, Department of Cardiology, Stavanger, Norway
    • University of Bergen, Institute of Internal Medicine, Norway

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

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☆ 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

Resuscitation
Volume 81, Issue 4 , Pages 493-497, April 2010

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