Vest cardiopulmonary resuscitation is based on concepts developed by a group of investigators at Johns Hopkins University in the mid-1980s. A vest, constructed similarly to a very large blood pressure cuff, is placed circumferentially around the chest ( Fig. 2). It is inflated and deflated at a frequency of 60/min and to a pressure of 250 mmHg with a pneumatic pump. This technique significantly increases maximum aortic pressure and coronary perfusion pressure when compared with conventional precordial compression. However, neither increases in initial resuscitability nor 24-h survival have been achieved as yet. A comprehensive clinical trial is in process.
Vest cardiopulmonary resuscitation utilizes compression forces that are evenly applied circumferentially around the chest; the intrathoracic volume is decreased in proportion to the pressure applied. Trauma is potentially minimized because the compression forces are distributed circumferentially rather than localized to the sternum.
Only incomplete clinical data on vest cardiopulmonary resuscitation are currently available. As yet, no lower incidence of trauma or improved outcome compared with conventional precordial compression have been demonstrated. It may be uniquely useful in transport vehicles, elevators, and other constricted surroundings.
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