Annals of emergency medicine
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Comparative Study
Differences in cerebral and myocardial perfusion during closed-chest resuscitation.
Substantial differences in cerebral and myocardial blood flow occur during cardiac arrest and artificial circulatory support using closed-chest techniques. This inequality can be explained by differences in generated driving pressures across the cerebral resistance vessels and the coronary vascular bed. ⋯ Contemporary cardiopulmonary resuscitation investigations are addressing this problem. Cardiac and cerebral resuscitation techniques must develop in parallel before clinically meaningful results can be obtained.
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Current standards for ventilation during cardiopulmonary resuscitation are not supported by recent and ongoing investigation. This is particularly true in victims with an unprotected airway. Currently used flow rates and inspiratory times predispose to gastric insufflation and its complications. Potential changes and corrections that may benefit the victim of cardiac arrest are reviewed.