Summary
Interposed abdominal compression in cardiopulmonary arrest: a critical review of the literature
Noval De La Torre A, Galván Sasía V
Affiliation of the authors
Servicio de Urgencias. Hospital Universitario Insular de Gran Canaria, España.
DOI
Quote
Noval De La Torre A, Galván Sasía V. Interposed abdominal compression in cardiopulmonary arrest: a critical review of the literature. Emergencias. 2009;21:17-22
Summary
Objective: To determine whether interposed abdominal compression during
cardiopulmonary resuscitation is a technique worth considering on the basis of
published evidence.
Method: A literature search was performed on PubMed for the period January through
December 2007 using the key words: interposed abdominal compression alone or in
combination with chest compression or cardiopulmonary resuscitation. We selected only
those studies that evaluated interposed abdominal compression. A total of 42 articles
were found; 17 were reviews of the literature or articles on the history of the technique
and 25 were clinical studies of different types and measuring a number of variables:
blood pressure, cardiac output, survival, etc. These clinical studies were grouped
according to the variable measured in order to compare results.
Results: Some of the studies point to the advantages of interposed abdominal
compression while others cast doubt on its utility; very few presented statistically
significant evidence in favor of interposed abdominal compression, and benefits
involved very specific measures. According to the studies reviewed, interposed
abdominal compression increases venous return, improving cardiac filling and, hence,
cardiac output during cardiopulmonary resuscitation. It increases diastolic pressure in
the thoracic aorta, favoring coronary artery perfusion during the phase of chest
relaxation. It therefore increases survival among patients who require cardiopulmonary
resuscitation.
Conclusions: None of the studies reviewed found interposed abdominal compression to
offer a statistically significant advantage in comparison with standard cardiopulmonary
resuscitation. However, the outcome measures in many of those studies suggest that this
technique could actually be effective, justifying a trial to determine whether it is really
useful.