Recent advances in mechanical cardiopulmonary resuscitation devices

Over the past 40 years since standard closed-chest cardiopulmonary resuscitation was first described, several mechanical devices have been developed to increase vital organ perfusion in patients in cardiac arrest. The newer approaches aim to increase forward blood flow by increasing intrathoracic pressures and by direct cardiac compression during the "compression phase." Equally important is the enhancement of venous return during the decompression phase of cardiopulmonary resuscitation. New approaches designed to increase venous return to the thorax during cardiopulmonary resuscitation include innovations that decrease "decompression phase" intrathoracic pressure and those that alternate abdominal compression with chest wall compression. The potential clinical value of these newer mechanical approaches is reviewed. In addition, some devices in the development stage are described. 1999 Lippincott Williams & Wilkins, Inc.