Figure 8. Techniques and mechanisms
of cardiac massage. Conventional
closed-chest compressions generate forward
blood flow via 1 or both of the
mechanisms depicted in the top 2 panels,
known as the heart pump and the
chest pump models, respectively (A and
B). Several alternative methods of cardiac
massage have been studied. Loaddistributing
band CPR (C) raises intrathoracic
pressure and, with it, systolic
pressure via the chest pump model.
Active compression decompression (D)
was designed to augment venous blood
return via increased negative intrathoracic
pressure, which may be improved
with an impedance threshold device.
Interposed abdominal counterpulsation
(E) may augment perfusion by increasing
diastolic aortic pressure or by several
other proposed mechanisms.
Figure 9. Survival from ventricular fibrillation before and after
implementation of rapid defibrillation programs. Most sites more
than doubled the likelihood of patients being discharged alive
after suffering from a ventricular fibrillation arrest by focusing on
immediate delivery of electric therapy at the time of arrest.
2846 Circulation December 19/26, 2006
Figure 8. Techniques and mechanisms
of cardiac massage. Conventional
closed-chest compressions generate forward
blood flow via 1 or both of the
mechanisms depicted in the top 2 panels,
known as the heart pump and the
chest pump models, respectively (A and
B). Several alternative methods of cardiac
massage have been studied. Loaddistributing
band CPR (C) raises intrathoracic
pressure and, with it, systolic
pressure via the chest pump model.
Active compression decompression (D)
was designed to augment venous blood
return via increased negative intrathoracic
pressure, which may be improved
with an impedance threshold device.
Interposed abdominal counterpulsation
(E) may augment perfusion by increasing
diastolic aortic pressure or by several
other proposed mechanisms.
Figure 9. Survival from ventricular fibrillation before and after
implementation of rapid defibrillation programs. Most sites more
than doubled the likelihood of patients being discharged alive
after suffering from a ventricular fibrillation arrest by focusing on
immediate delivery of electric therapy at the time of arrest.
2846 Circulation December 19/26, 2006
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