Interposed abdominal compression

Interposed abdominal compression is intended to increase venous return of blood from the viscera to the right atrium. At the same time, the concurrent compression of the abdominal aorta is intended to decrease infradiaphragmatic runoff of aortic blood flow. Consequently, venous return, forward blood flow into the aorta, and delayed runoff into the lower body preserve vital blood flow to the coronary and cerebral circuits. During the relaxation phase of precordial compression a second rescuer compresses the abdomen in the midline with a force equivalent to 200 mmHg at a site equidistant from the xyphoid process and the umbilicus ( Fig 1).

Practical guidelines for securing the optimal compression force to the abdomen are still lacking. However, there is evidence that interposed abdominal compression may substantially increase the cardiac output and coronary perfusion pressure generated during precordial compression. In the setting of in-hospital cardiac arrest, this technique is reported to increase initial resuscitability and the number of neurologically intact patients discharged from the hospital ( Sackeia/ 1992). However, as yet there is no persuasive proof that interposed abdominal compression improves the outcome of cardiopulmonary resuscitation in settings of out-of-hospital cardiac arrest.

Fig. 1 Interposed abdominal compression.

Complications of interposed abdominal compression are similar to those of external precordial compression. Contrary to expectation, traumatic injury to the abdominal viscera is not significantly increased.

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