Hemodynamics, Survival Benefits, and Complications of Interposed Abdominal Compression during Cardiopulmonary Resuscitation

OBJECTIVE: To review and describe the hemodynamics and mechanisms of benefit of interposed abdominal compression cardiopulmonary resuscitation (IAC-CPR) as well as the current complications and survival data with the use of IAC-CPR. METHODS: Critical review of selected, published English-language studies analyzing IAC-CPR. Overview of hemodynamic effects, complications, and survival data of IAC-CPR vs standard CPR. RESULTS: Several investigators have demonstrated improvements in coronary perfusion, carotid and cerebral blood flows, and augmented venous return using IAC-CPR compared with standard CPR. Recently, IAC-CPR has been shown to improve survival from in-hospital cardiac arrest. To date, there has been no increase in complications seen with the use of abdominal compression during CPR. RECOMMENDATIONS: IAC-CPR should be considered an adjunct to standard CPR for adult patients experiencing in-hospital cardiac arrest, after an adequate airway has been secured. More research is needed before IAC-CPR can be recommended for out-of-hospital cardiac arrest, for patients who have not been intubated, or for children.