ReviewJournal of the Intensive Care Society2019
Blood flow maintenance by cardiac massage during cardiopulmonary resuscitation: Classical theories, newer hypotheses, and clinical utility of mechanical devices.
Review in Journal of the Intensive Care Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Comparison of different airway pressures in (synchronized) ventilation during cardiopulmonary resuscitation in pigs.Resuscitation plus · 2026Article
- Hemodynamics of active abdominal compression decompression CPR in a rat model of multiple rib fractures with asphyxial cardiac arrest.Scientific reports · 2025Article
- Introducing the Safe Brain Initiative's EEG boot camp for anaesthesia for standardised training on how to use the electroencephalogram for perioperative care.BMC anesthesiology · 2025Article
- Head Up Cardiopulmonary Resuscitation: Novel Physiological Discoveries and Latest Clinical Outcomes.Medical research archives · 2025Article
- Echocardiographic clues of the "atrial pump mechanism" during cardiopulmonary resuscitation.Internal and emergency medicine · 2025Article
- Right ventricular pressure-volume relations and effects of selective vena cava occlusion during cardiopulmonary resuscitation.PloS one · 2025Article
- Physiology-Guided Resuscitation: Monitoring and Augmenting Perfusion during Cardiopulmonary Arrest.Journal of clinical medicine · 2024Review
- Use of Mechanical Chest Compression for Resuscitation in Out-Of-Hospital Cardiac Arrest-Device Matters: A Propensity-Score-Based Match Analysis.Journal of clinical medicine · 2023Article
- Lapses of the Heart: Frequency and Subjective Salience of Impressions Reported by Patients after Cardiac Arrest.Journal of clinical medicine · 2023Article
- Synchronized ventilation during resuscitation in pigs does not necessitate high inspiratory pressures to provide adequate oxygenation.World journal of emergency medicine · 2023Article
- Mathematical Model of Blood Circulation with Compression of the Prototype's Mechanical CPR Waveform.Bioengineering (Basel, Switzerland) · 2022Article
- Advanced interventions in the pre-hospital resuscitation of patients with non-compressible haemorrhage after penetrating injuries.Critical care (London, England) · 2022Review
- Transesophageal echocardiography in patients with cardiac arrest: from high-quality chest compression to effective resuscitation.Journal of echocardiography · 2021Review
- A review of ventilation in adult out-of-hospital cardiac arrest.Journal of the American College of Emergency Physicians open · 2020Review
- Combination of cardiac and thoracic pump theories in rodent cardiopulmonary resuscitation: a new method of three-side chest compression.Intensive care medicine experimental · 2019Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The mechanisms by which closed chest cardiac massage produces and maintains blood flow during cardiopulmonary resuscitation are still debated. To date, two main theories exist: the "cardiac pump", which assumes that blood flow is driven by direct cardiac compression and the "chest pump", which hypothesizes that blood flow is caused by changes in intrathoracic pressure. Newer hypotheses including the "atrial pump", the "lung pump", and the "respiratory pump" were also proposed. We reviewed studies supporting these different theories as well as the clinical evidences on the utility of mechanical devices proposed to optimize cardiopulmonary resuscitation, in view of their pathophysiological assumptions with regard to the underlying theory. On the basis of current evidence, a single theory is probably not sufficient to explain how cardiac massage produces blood flow. This suggests that different simultaneous mechanism might be involved. The relative importance of these mechanisms depends on several factors, including delay from collapse to starting of resuscitation, compression force and rate, body habitus, airway pressure, and presenting electrocardiogram. The complexity of the physiologic events occurring during cardiopulmonary resuscitation, together with the need of adequate training for a correct and prompt utilization of mechanical devices, might also partially explain the disappointing results of these devices in most clinical studies.
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