Mechanisms of Central Hemodynamic Changes Due to Limb Tourniquets and Cuffs: Mathematical Modeling Studies with Implications for Cardiopulmonary Resuscitation.

Matt T Oberdier, Luca Neri, Alberto P Avolio, Henry R Halperin

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Article in Annals of biomedical engineering, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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4 authors.

Matt T OberdierDepartment of Medicine, Division of Cardiology, Johns Hopkins University, 1721 East Madison Street, Traylor Hall 901, Baltimore, MD, 21205, USA. moberdi1@jh.edu.ORCID http://orcid.org/0000-0002-9486-2220

Luca NeriDepartment of Medicine, Division of Cardiology, Johns Hopkins University, 1721 East Madison Street, Traylor Hall 901, Baltimore, MD, 21205, USA.

Alberto P AvolioMacquarie Medical School, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, Australia.

Henry R HalperinDepartment of Medicine, Division of Cardiology, Johns Hopkins University, 1721 East Madison Street, Traylor Hall 901, Baltimore, MD, 21205, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLimb compression is proposed as a supplement to cardiopulmonary resuscitation (CPR) because it has the potential to increase central organ blood flow rates. This is significant because CPR only has a survival rate of 10-15%, and survival depends on the amount of blood flow generated during CPR. However, the underlying physiological mechanisms are not understood, thereby limiting optimal application of limb compression during CPR. Therefore, this study addressed the hypothesis that circuit pathway reduction, volume displacement, and wave reflection mechanisms contribute to higher central organ blood flow rates. Mathematical models were utilized because modeling is the only way to isolate physiological mechanisms.

methodsThis study utilized two validated mathematical models that were minimally altered to investigate limb compression during CPR. A lumped-parameter model addressed circuit pathway reduction and volume displacement while the other model isolated wave reflections.

resultsRelative to standard CPR, the model simulating circuit pathway reduction via CPR with tourniquets predicted increases of cerebral and coronary flow rates by 3% each while the model simulating volume displacement via CPR with constant pressure cuffs predicted increased cerebral and coronary flow rates by up to 74% and 109%, respectively. Furthermore, the wave reflection model predicted increases in blood flow rates of major cerebral arteries up to 11% and across all major abdominal arteries up to 27%.

conclusionAll limb compression configurations and modalities resulted in increased predicted central organ blood flow rates with volume displacement, wave reflection, and circuit pathway reduction mechanisms, in that order, being most influential.

Indexed as

Cardiopulmonary ResuscitationExtremitiesHemodynamicsModels, CardiovascularTourniquetsHumansBlood flowCardiac arrestCardiopulmonary resuscitationHemodynamicsLimb compressionMathematical model

Identifiers

PMID41398123

DOI10.1017/S0022112077002031

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.