Methods for Calculating Coronary Perfusion Pressure During CPR
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Coronary perfusion pressure (CPP) is a major indicator of the effectiveness of cardiopulmonary resuscitation in human and animal research studies, however, methods for calculating CPP differ among research groups. Here we compare the 6 published methods for calculating CPP using the same data set of aortic (Ao) and right atrial (RA) blood pressures. CPP was computed using each of the 6 calculation methods in an anesthetized pig model, instrumented with catheters with Cobe pressure transducers. Aortic and right atrial pressures were recorded continuously during electrically induced ventricular fibrillation and standard AHA CPR. CPP calculated from the same raw data set by the 6 calculation methods ranged from −1 (signifying retrograde blood flow) to 26 mmHg (mean ± SD of 15 ± 11 mmHg). The CPP achieved by standard closed chest CPR is typically reported as 10–20 mmHg. Within a single study the CPP values may be comparable; however, the CPP values for different studies may not be a reliable indicator of the efficacy of a given CPR method. Electronically derived true mean coronary perfusion pressure is arguably the gold standard method for representing coronary perfusion pressure.
KeywordsCardiopulmonary resuscitation Ventricular fibrillation Coronary perfusion pressure Blood pressure
Supported in part by National Institutes of Health (NIBIB Grant NGAR2IEBOO1540) and a grant from the Purdue Trask Fund.
- Babbs CF. Interposed Abdominal Compression-CPR: a case study in cardiac arrest research. Ann Emerg Med. 1993;22:32/24-40/32.Google Scholar
- Fenely MP, Maier GW, Kern KB, Gaynor JW, Gall SA, Sanders AB, et al. Influence of compression rate on initial success of resuscitation and 24 h survival after prolonged manual cardiopulmonary resuscitation in dogs. Circulation. 1988;77:240–50.Google Scholar
- Geddes LA. Cardiovascular devices and their applications. New York: Wiley; 1984.Google Scholar
- Kern KB. Coronary perfusion pressure during cardiopulmonary resuscitation. Baillière’s Clin Anesth. 2000;14:591–609.Google Scholar
- Strohmenger HU, Lindner KH, Keller A, Lindner IM, Pfenninger E, Bothner U. Effects of graded doses of vasopressin on median fibrillation frequency in a porcine model of cardiopulmonary resuscitation: results of a prospective, randomized, controlled trial. Crit Care Med. 1996;24:1360–5.PubMedCrossRefGoogle Scholar