A new cardiopulmonary resuscitation method using only rhythmic abdominal compression is hard

摘要

We read with great interest the article by Geddes et al. concerning a new CPR (cardiopulmonary resuscitation) method using OAC (only rhythmic abdominal compression). However, we note several issues. First, the authors tried investigating how to maintain coronary perfusion when CPA (cardiopulmonary arrest) with ventricular fibrillation had occurred. But the most important objective of CPR is not to maintain coronary perfusion, but it is to protect the brain from the hypoxia so that patients would gain favorable neurological outcome . Thus, we would like to know data about the brain perfusion in their experiments if available. Second, the first action of CPR is to keep airway open. During the time when emergency medical technicians transport patients with cardiac arrest to hospitals, many patients experience the vomiting of their gastric contents because their stomachs are often full and the mask-bag ventilations can cause spouting of the gastric contents. The vomiting sometimes leads to serious respiratory compromise by obstructing upper airway. Abdominal compression procedures may cause a higher risk for the airway compromise due to retrograde propulsion of the gastric contents into oropharyngeal cavity. Third, they provided data about the incidence of rib fractures as adverse effects of CPR. However, this may not be so much important when patients are going to die or not.