Alternative Positions for Cardiopulmonary Resuscitation
External cardiac compressions are the cornerstone of current life support protocols in case of cardiac arrests. Though supine body positioning is considered the optimum during managing such cases; others alternatives have also reported. The latter can be lifesaving in certain situations where supine positioning is either difficult or time consuming. The present article presents the available literature about cardiopulmonary resuscitation in prone, lateral and head up position.
Cardiopulmonary Resuscitation, Cardiac Arrest, Body Positioning
[1]
Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA 1960; 173: 1064-1067.
[2]
Aitchison R, Aitchison P, Wang E, Kharasch M. A review of cardiopulmonary resuscitation and its history. Dis Mon 2013; 59(5):165-167. doi: 10.1016/j.disamonth.2013.03.002.
[3]
International Liaison committee on Resuscitation. 2005 International Consensus on Cardiopulmonary Resuscitation on emergency Cardiovascular Care Science with Treatment Recommendation. Circulation 2005; 111 (Suppl):206-2011.
[4]
Monsieurs KG, Nolan JP, Bossaert LL, Greif R, Maconochie IK, Nikolaou IN, et al. European Guidelines for Resuscitation 2015. Resuscitation 2015; 95:1-80.
[5]
Lavonas EJ, Drennan IR, Gabrielli A, Heffner AC, Hoyte CO, Orkin AM, Sawyer KN, Donnino MW. Part 10: special circumstances of resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015; 132 (Suppl 2):S501–S518.
[6]
McNeil E. Re-evaluation of cardiopulmonary resuscitation. Resuscitation 1989; 18:1-5.
[7]
Dryden GE, Benz J. Efficiency studies: aspiration, chest injury and prone CPR. J Indiana State Med Assoc. 1983;76(4):269-270
[8]
Atkinson M. The efficacy of cardiopulmonary resuscitation in the prone position. Crit Care Resusc 2000;2(3):188-90.
[9]
Mazer SP, Weisfeldt M, Bai D, Cardinale C, Arora R, Ma C, Sciacca RR, Chong D, Rabbani LE. Reverse CPR: a pilot study of CPR in the prone position. Resuscitation 2003;57(3):279-85.
[10]
Wei J, Tung D, Sue SH, Wu SV, Chuang YC, Chang CY. Cardiopulmonary resuscitation in prone position: a simplified method for outpatients. J Chin Med Assoc. 2006;69(5):202-206. doi:10.1016/S1726-4901(09)70219-9
[11]
Sun WZ, Huang FY, Kung KL, Fan SZ, Chen TL. Successful resuscitation of two patients in the prone position using reverse precordial compressions. Anesthesiology. 1992; 77(1):202-204.
[12]
Loewenthal A, De Albuquerque AM, Lehmann-Meurice C, Otteni JC. Efficacy of external cardiac massage in a patient in the prone position. Ann Fr Anesth Reanim. 1993;12(6):587-589
[13]
Tobias JD, Mencio GA, Atwood R, Gurwitz GS. Intraoperative cardiopulmonary resuscitation in the prone position. J Pediatr Surg. 1994; 29(12):1537-1538
[14]
Kelleher A, Mackersie A. Cardiac arrest and resuscitation of a 6-month old achondroplastic baby undergoing neurosurgery in the prone position. Anaesthesia. 1995;50(4):348-350
[15]
Dequin PF, Hazouard E, Legras A, Lanotte R, Perrotin D. Cardiopulmonary resuscitation in the prone position: Kouwenhoven revisited. Intensive Care Med. 1996; 22(11):1272.
[16]
Dooney N. Prone CPR for transient asystole during lumbosacral spineal surgery. Anaesth Intensive Care. 2010; 38(1):212-213.
[17]
Haffner E, Sostarich AM, Fösel T. Successful cardiopulmonary resuscitation on prone position. Anesthetist 2010; 59(12):1099-1101. doi: 10.1007/s00101-010-1785-8
[18]
Gomes DdS, Bersot CDA. Cardiopulmonary resuscitation in the prone position. Open J Anesth. 2012;2:199-201
[19]
Kaur J, Kane D, Shinde S, Dongre V. Cardiac arrest in prone position: When do I make my patient supine? Anesth Analg 2016;123 (Suppl 3):47
[20]
Kwon MJ, Kim EH, Song IK, Lee JH, Kim HS, Kim JT. Optimizing Prone Cardiopulmonary Resuscitation: Identifying the Vertebral Level Correlating With the Largest Left Ventricle Cross-Sectional Area via Computed Tomography Scan. Anesth Analg. 2017;124(2):520-523. doi: 10.1213/ANE.0000000000001369.
[21]
Miranda CC, Newton MC. Successful defibrillation in the prone position. Br J Anaesth. 2001;87(6):937-938. doi: 10.1007/s00101-010-1785-8
[22]
Kaur J. Kane D, Shinde S, Donge V. Cardiac arrest in prone position: When do I make my patient supine? Anesth Analg 2016; 123 (Suppl 3): PRO30 doi: 10.1213/01.ane.0000492440.41192.e3
[23]
Tofil NM, Dollar J, Zinkan L, Youngblood AQ, Peterson DT, White ML, Stooksberry TN,Jarrell SA, King C. Performance of anesthesia residents during a simulated prone ventricular fibrillation arrest in an anesthetized pediatric patient. Paediatr Anaesth 2014; 24(9):940-4. doi: 10.1111/pan.12406.
[24]
Yien HW. Is the upside-down position better in Cardiopulmonary Resuscitation? J Clin Med Assoc. 2006; 69(5):199-201.
[25]
Butcher M, Ip J, Bushby D, Yentis SM. Efficacy of cardiopulmonary resuscitation in the supine position with manual displacement of the uterus vs lateral tilt using a firm wedge: a manikin study. Anaesthesia. 2014; 69(8):868-71. doi: 10.1111/anae.12714
[26]
Wang KY, Yeh YC, Jean WH, Fan SZ. Cardiopulmonary resuscitation in the lateral position for an infant with an anterior mediastinal mass. Acta Anaesthesiol Taiwan. 2009;47(1):40-3. doi: 10.1016/S1875-4597(09)60020-5.
[27]
Abraham M, Wadhawan M, Gupta V, Singh AK. Cardiopulmonary resuscitation in the lateral position: is it feasible during pediatric intracranial surgery? Anesthesiology. 2009; 110(5): 1185-1186. doi: 10.1097/ALN.0b013e31819f7b2b
[28]
Takei T, Nakazawa K, Ishikawa S, Uchida T, Makita K. Cardiac arrest in the left lateral decubitus position and extracorporeal cardiopulmonary resuscitation during neurosurgery: A case report. J Anesth. 2010; 24:447–451. doi: 10.1007/s00540-010-0911-8
[29]
Bengali R, Janik LS, Kurtz M, McGovern F, Jiang Y. Successful cardiopulmonary resuscitation in the lateral position during intraoperative cardiac arrest. Anesthesiology. 2014; 120:1046–1049. doi: 10.1097/ALN.0b013e3182923eb9
[30]
Khan AM, Kapoor MC, Deuri BP. Cardiopulmonary Resuscitation in Lateral decubitus position. J Anesth Crit Care Open Access 2015, 3(4): 00104
[31]
Bhatnagar V, Jinjil K, Raj P. Complete recovery after cardiopulmonary resuscitation in the lateral decubitus position: A report of two cases. Saudi J Anaesth. 2016;10(3):365-366. doi: 10.4103/1658-354X.174921
[32]
Zadini F, Newton E, Abdi AA, Lenker J, Zadini G, Henderson SO. Use of Trendeleburg position in the porcine model improves carotid flow during cardiopulmonary resuscitation. West J Emerg Med. 2008;9(4):206-211.
[33]
Debaty G, Shin SD, Metzger A, Kim T, Ryu HH, Rees J, McKnite S, Matsuura T, Lick M, Yannopoulos D, Lurie K. Tilting for perfusion: Head-up position during cardiopulmonary resuscitation improves brain flow in a porcine model of cardiac arrest. Resuscitation. 2015; 87:38–43. doi: 10.1016/j.resuscitation.2014.11.019.
[34]
Ryu HH, Moore JC, Yannopoulos D, Lick M, McKnite S, Shin SD, Kim TY, Metzger A, Rees J, Tsangaris A, Debaty G, Lurie KG. The Effect of Head Up Cardiopulmonary Resuscitation on Cerebral and Systemic Hemodynamics. Resuscitation 2016; 102:29-34. doi: 10.1016/j.resuscitation.2016.01.033
[35]
Moore JC, Holley JE Jr, Frascone RJ, et al. Head-up position lowers intracranial pressure in a human cadaver model of cardiopulmonary resuscitation [poster]. American Heart Association Resuscitation Science Symposium and Scientific Sessions: New Orleans, 2016.
[36]
Frascone RJ. The perfusing cadaver model and head-up CPR. JEMS 2017;1:33-37.
[37]
Moore JC, Bartos JA, Matsuura TR, Yannopoulos D. The future is now: neuroprotection during cardiopulmonary resuscitation. Curr Opin Crit Care 2017, 23:215–222 doi:10.1097/MCC.0000000000000405
