Cardiopulmonary Resuscitation

  • Ernest F. J. Block
  • Jay L. Falk


The purpose of cardiopulmonary resuscitation (CPR) and advanced life support (ALS) in the critical care setting is to reverse sudden, unexpected death resulting from reversible disease processes or iatrogenic complications. As an overriding outcome variable, acceptable neurologic function is critical, so these interventions should more accurately be described as cardiopulmonary-cerebral resuscitation (CPCR) (1).


Cardiac Arrest Ventricular Fibrillation Cardiopulmonary Resuscitation Laryngeal Mask Airway Chest Compression 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Safar P. On the history of modern resuscitation. Crit Care Med 1996; 24 (2 Suppl): S3–11.PubMedCrossRefGoogle Scholar
  2. 2.
    Perkins JF. Historical development of respiratory physiology. In: Fenn WO, Rahn H, eds. Handbook. of physiology: a critical, comprehensive presentation of physiological knowledge and concepts Washington, DC: American Physiological Society, 1964: 1–62.Google Scholar
  3. 3.
    Colice GL. Historical perspective of the development of mechanical ventilation. In: Tobin MJ, ed. Principles and practice of mechanical ventilation. New York: McGraw Hill, 1994: 1–36.Google Scholar
  4. 4.
    Safar P. History of cardiopulmonary-cerebral resuscitation. In:. Kaye W, Bircher NG, eds. Cardiopulmonary resuscitation. New York: Churchill Livingstone, 1989; 1–53.Google Scholar
  5. 5.
    Dripps RD, Kirby CK, Johnson J, Erb WH. Cardiac resuscitation. Ann Surg 1948; 127: 592–604.CrossRefGoogle Scholar
  6. 6.
    Kouwenhoven WB, Langworthy OR. Cardiopulmonary resuscitation. An account of forty-five years of research. Johns Hopkins Med J 1973; 32: 186–93.Google Scholar
  7. 7.
    Jude JR, Kouwenhoven WB, Knickerbocker GG. Cardiac arrest. Report of application of external cardiac massage on 118 patients. JAMA 1961; 178: 1063–70.PubMedCrossRefGoogle Scholar
  8. 8.
    Zoll PM, Linenthal AJ, Gibson W, Paul MH, Norman LR Termination of ventricular fibrillation in man by externally applied electric countershock. N Engl J Med 1956; 254: 727–32.PubMedCrossRefGoogle Scholar
  9. 9.
    Cardiopulmonary resuscitation — Statement by the Ad Hoc Committee on Cardiopulmonary Resuscitation of the Division of Medical Sciences, National Academy of Sciences-National Research Council. JAMA 1966; 198: 372–9.CrossRefGoogle Scholar
  10. 10.
    Tomlinson T, Brody H. Futility and the ethics of resuscitation. JAMA 1990; 264: 1276–80.PubMedCrossRefGoogle Scholar
  11. 11.
    Bedell SE, Delbanco TL, Cook EF, Epstein FH. Survival after cardiopulmonary resuscitation in the hospital. N Engl J Med 1983: 309: 569–76.PubMedCrossRefGoogle Scholar
  12. 12.
    Juchems R, Wahlig G, Frese W. Influence of age on the survival rate of out-of-hospital and in-hospital resuscitation. Resuscitation 1993; 26: 23–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Rozenbaum EA, Shenkman L. Predicting outcome of inhospital cardiopulmonary resuscitation. Crit Care Med 1988; 16: 583–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Waisel DB, Truog RD. The cardiopulmonary resuscitation-not-indicated order: futility revisited. Ann Intern Med 1995; 122: 304–8.PubMedGoogle Scholar
  15. 15.
    Lantos JD, Singer PA, Walker RM, Gramelspacher GP, Shapiro GR, Sanchez-Gonzalez MA, Stocking CB, Miles SH, Siegler M. The illusion of futility in clinical practice. Am J Med 1989; 87: 81–4.PubMedCrossRefGoogle Scholar
  16. 16.
    Baker R. The ethics of medical futility. Crit Care Clin 1993; 9: 575–84.PubMedGoogle Scholar
  17. 17.
    Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA 1960; 173: 1064–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Deshmukh HG, Weil MH, Rackow EC, Trevino R, Bisera J. Echocardiographic observations during cardiopulmonary resuscitation: a preliminary report. Crit Care Med 1985; 13: 904–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Weale FE, Rothwell-Jackson RL. The efficiency of cardiac massage. Lancet 1962; 1: 990–2.PubMedCrossRefGoogle Scholar
  20. 20.
    Weisfeldt ML, Chandra N. Physiology of cardiopulmonary resuscitation. Annu Rev Med 1981; 32: 435–42.PubMedCrossRefGoogle Scholar
  21. 21.
    Criley JM, Blaufuss AJ, Kissel GL. Cough induced cardiac compression. Self-administered form of cardiopulmonary resuscitation. JAMA 1976; 236: 1246–50.PubMedCrossRefGoogle Scholar
  22. 22.
    Niemann JT, Rosborough J, Hausknecht M, Brown D, Criley JM. Cough-CPR: documentation of systemic perfusion in man and in an experimental model: a “window” to the mechanism of blood flow in external CPR. Crit Care Med 1980; 8: 141–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Weisfeldt ML, Chandra N, Tsitlik J. Increased intrathoracic pressure -not direct heart compression- -causes the rise in intrathoracic vascular pressures during CPR in dogs and pigs. Crit Care Med 1981; 9: 377–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Gazmuri RJ, Weil MH, Bisera J, Tang W, Fukui M, McKee D. Myocardial dysfunction after successful resuscitation from cardiac arrest. Crit Care Med 1996; 24: 992–1000.PubMedCrossRefGoogle Scholar
  25. 25.
    Halle AA 3d. Alternatives to conventional chest compression. New Horiz 1997; 5: 112–9.PubMedGoogle Scholar
  26. 26.
    Paradis NA, Martin GB, Rivers EP, Goetting MG, Appleton TJ, Feingold M, Nowak RM. Coronary perfusion pressure and the return of spontaneous circulation. JAMA 1990; 263: 1106–13.PubMedCrossRefGoogle Scholar
  27. 27.
    Wenzel V, Lindner KH, Prengel AW, Strohmenger HU. Effect of phased chest and abdominal compression-decompression cardiopulmonary resuscitation on myocardial and cerebral blood flow in pigs. Crit Care Med 2000; 28: 1107–12.PubMedCrossRefGoogle Scholar
  28. 28.
    Tang W, Weil MR, Sat Y, Sun S, Wang Q, Bisera J. Phased chest and abdominal compression-decompression - a new option for cardiopulmonary resuscitation (CPR). Crit Care Med 1996; 24 (suppl): A42.Google Scholar
  29. 29.
    Halperin HR, Guerci AD, Chandra N, Herskowitz A, Tsitlik JE, Niskanen RA, Wurmb E, Weisfeldt ML. Vest inflation without simultaneous ventilation during cardiac arrest in dogs: improved survival from prolonged cardiopulmonary resuscitation. Circulation 1986; 74: 1407–15.PubMedCrossRefGoogle Scholar
  30. 30.
    Halperin HR, Tsitlik E, Gelfand M, Weisfeldt ML, Gruben KG, Levin HR, Rayburn BK, Chandra NCGoogle Scholar
  31. Scott CJ, Kreps BJ, Siu CO. A preliminary study of cardiopulmonary resuscitation by circumfei Burial compression of the chest with use of a pneumatic vest. N Engl J Med 1993; 329: 762–8.PubMedCrossRefGoogle Scholar
  32. 31.
    Weil MH. Research on CPR: reordering priorities. New Horiz 1997; 5: 106–11.PubMedGoogle Scholar
  33. 32.
    Tang W, Weil MH, Sun S, Kette D, Kette F, Gazmuri RJ, O’Connell F, Bisera J. Cardiopulmonary resuscitation by precordial compression but without mechanical ventilation. Am J Respir Crit Care Med 1994; 150: 1709–13.PubMedCrossRefGoogle Scholar
  34. 33.
    Noc M, Weil MH, Tang W, Turner T, Fukui M. Mechanical ventilation may not be essential for initial cardiopulmonary resuscitation. Chest 1995; 108; 821–7.PubMedCrossRefGoogle Scholar
  35. 34.
    Berg RA, Kern KB, Sanders AB, Otto CW, Hilwig RW, Ewy GA. Bystander cardiopulmonary resuscitation. Is ventilation necessary? Circulation 1993; 88: 1907–15.PubMedCrossRefGoogle Scholar
  36. 35.
    Cohen TJ, Reid PR, Mower MM, Mirowski M, Aarons D, Juanteguy J, Veltri EP. The automatic implantable cardioverter-defibrillator. Long-term clinical experience and outcome at a hospital without an open-heart surgery program. Arch Intern Med 1992; 152: 65–9.PubMedCrossRefGoogle Scholar
  37. 36.
    Weaver WD, Hill D, Fahrenbruch CE, Copass MK, Martin JS, Cobb LA, Hallstrom AP. Use of the automatic external defibrillator in the management of out-of-hospital cardiac arrest. N Engl J Med 1988; 319: 661–6.PubMedCrossRefGoogle Scholar
  38. 37.
    Omato JP, Hallagan LF, McMahan SB, Peeples EH, Rostafinski AG. Attitudes of BCLS instructors about mouth-to-mouth resuscitation during the AIDS epidemic. Ann Emerg Med 1990; 19: 151–6.CrossRefGoogle Scholar
  39. 38.
    Risk of infection during CPR training and rescue: supplemental guidelines. The Emergency Cardiac Care Committee of the American Heart Association. JAMA 1989;262:2714–15.Google Scholar
  40. 39.
    Doerges V, Sauer C, Ocker H, Wenzel V, Schmucker P. Airway management during cardiopulmonary resuscitation-a comparative study of bag-valve-mask, laryngeal mask airway and combitube in a bench model. Resuscitation 1999; 41: 63–9.PubMedCrossRefGoogle Scholar
  41. 40.
    Stone BJ, Chantler PJ, Baskett PJ. The incidence of regurgitation during cardiopulmonary resuscitation: a comparison between the bag valve mask and laryngeal mask airway. Resuscitation 1998; 38: 3–6.PubMedCrossRefGoogle Scholar
  42. 41.
    Britten S, Palmer SH, Snow TM. Needle thoracocentesis in tension pneumothorax: insufficient cannula length and potential failure. Injury 1996; 27: 321–2.PubMedCrossRefGoogle Scholar
  43. 42.
    Gueugniaud PY, Mols P, Goldstein P, Pham E, Dubien PY, Deweerdt C, Vergnion M, Petit P, Carli P. A comparison of repeated high doses and repeated standard doses of epinephrine for cardiac arrest outside the hospital. European Epinephrine Study Group. N Engl J Med 1998; 339: 1595–601.PubMedCrossRefGoogle Scholar
  44. 43.
    Brown CG, Martin DR, Pepe PE, Stueven H, Cummins RO, Gonzalez E, Jastremski M. A comparison of standard-dose and high-dose epinephrine in cardiac arrest outside the hospital. The Multicenter High-Dose Epinephrine Study Group. N Engl J Med 1992; 327: 1051–5.PubMedCrossRefGoogle Scholar
  45. 44.
    Gedeborg R, Silander HC, Ronne-Engstrom E, Rubertsson S, Wiklund L. Adverse effects of high- dose epinephrine on cerebral blood flow during experimental cardiopulmonary resuscitation. Crit Care Med 2000; 28: 1423–30.PubMedCrossRefGoogle Scholar
  46. 45.
    diMarco JP, Sellers TD, Lerman BB, Greenberg ML, Berne RM, Belardinelli L. Diagnostic and therapeutic use of adenosine in patients with supraventricular tachyarrhythmias. J Am Coll Cardiol 1985; 6: 417–25.PubMedCrossRefGoogle Scholar
  47. 46.
    Guidelines for cardiopulmonary resuscitation and emergency cardiac care. Emergency Cardiac Care Committee and Subcommittees, American Heart Association. Part III. Adult advanced cardiac life support. JAMA 1992; 268: 2199–241.CrossRefGoogle Scholar
  48. 47.
    Niemann JT, Stratton SJ. Endotracheal versus intravenous epinephrine and atropine in out-of- hospital “primary” and postcountershock asystole. Crit Care Med 2000; 28: 1815–9.PubMedCrossRefGoogle Scholar
  49. 48.
    Brown CG, Dzwonczyk R, Martin DR. Physiologic measurement of the ventricular fibrillation ECG signal: estimating the duration of ventricular fibrillation. Ann Emerg Med 1993; 22: 70–4.PubMedCrossRefGoogle Scholar
  50. 49.
    Brown CG, Dzwonczyk R, Werman HA, Hamlin RL. Estimating the duration of ventricular fibrillation. Ann Emerg Med 1989; 18: 1181–5.PubMedCrossRefGoogle Scholar
  51. 50.
    Falk JL, Rackow EC, Weil MH. End-tidal carbon dioxide concentration during cardiopulmonary resuscitation. N Engl J Med 1988; 318: 607–11.PubMedCrossRefGoogle Scholar
  52. 51.
    Steedman DJ, Robertson CE. Measurement of end-tidal carbon dioxide concentration during cardiopulmonary resuscitation. Arch Emerg Med 1990; 7: 129–34.PubMedCrossRefGoogle Scholar
  53. 52.
    Sanders AB, Kern KB, Otto CW, Milander MM, Ewy GA. End-tidal carbon dioxide monitoring during cardiopulmonary resuscitation. A prognostic indicator for survival. JAMA 1989; 262: 1347–51.PubMedCrossRefGoogle Scholar
  54. 53.
    Sayah AJ, Peacock WF, Overton DT. End-tidal CO2 measurement in the detection of esophageal intubation during cardiac arrest. Ann Emerg Med 1990; 19: 857–60.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Ernest F. J. Block
    • 1
  • Jay L. Falk
    • 1
  1. 1.Orlando Regional Medical CenterOrlandoUSA

Personalised recommendations