Circulatory support during cardiac arrest using a pneumatic vest and abdominal binder with simultaneous high-pressure airway inflation.

Animal and clinical studies suggest that blood flow during closed-chest cardiopulmonary resuscitation (CPR) results from phasic intrathoracic pressure fluctuations produced by rhythmic sternal depressions rather than from cardiac compression. Using physiologic observations made in animals and human beings during circulatory collapse and vigorous coughing, a pneumatic thoracic vest garment and abdominal binder device has been designed to emulate "cough CPR." Hemodynamic findings and microsphere regional perfusion observed during cardiac arrest and airway/vest/binder inflation are comparable to those observed during simultaneous chest compression and pulmonary ventilation CPR (SCV-CPR). Resuscitation and survival using the device has been compared to survival rates using conventional closed-chest CPR. The vest/binder apparatus significantly improved the coronary perfusion gradient and survival. Further studies are in progress to determine the clinical utility of this promising resuscitation adjunct.