A Computer-based Study on the Effect of Sympathetic Activity during CPR

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Author Info

Alka Rachel John M. Manivannan Natesan Damodaran

Corresponding Author

Alka Rachel John
Touch Lab, Biomedical Research Group, Department of Applied Mechanics, IIT Madras, Chennai, India

A B S T R A C T

Purpose: In spite of extensive studies, the mechanism of cardiopulmonary resuscitation (CPR) has not been properly understood and a proper comprehension of the role of regulatory mechanisms of the cardiovascular system during CPR is unavailable. Using computational methods, we try to study the influence of sympathetic activation on the cardiac output and mean arterial pressure (MAP) during CPR at different compression pressures and rates. Methods: A computer model was used to investigate the effect of sympathetic activation during CPR. The model has a detailed representation of the cardiopulmonary resuscitation system and sympathetic control. Sympathetic activation during CPR was achieved through vital cardiac parameters such as contractility and peripheral resistance. We compared the cardiac output and MAP during CPR in four scenarios, namely with; (1) sympathetic activation of heart alone, (2) sympathetic activation of the peripheral arteries alone, (3) sympathetic activation of both heart and peripheral arteries, and (4) no sympathetic activation; for different compression pressures and rates. Results: The results show that the cardiac output and MAP increases with increasing compression pressures and rates during CPR with sympathetic activation of peripheral arteries. The sympathetic activation of peripheral arteries during CPR at the AHA and ERC recommended chest compression pressures and rates resulted in an increased MAP, an augmented aortic diastolic pressure and a decreased cardiac output. The results also show that cardiac output and MAP pressure increases with increasing compression rate during CPR with sympathetic activation of heart. There is a slight increase in the MAP but no substantial improvement in cardiac output during CPR with sympathetic activation of heart at the AHA and ERC recommended pressures and rates. Conclusions: It is observed from the study that sympathetic activation of heart during CPR may not be beneficial at the AHA and ERC recommended chest compression rates as it gives very little improvement in cardiac output and MAP. However, performing CPR at higher compression rate may improve the chances of resuscitation when drugs are used to induce sympathetic activity in the heart. The augmented aortic diastolic pressure during CPR with sympathetic activation of peripheral arteries at the AHA and ERC recommended compression pressure and rates can improve the myocardial perfusion, but the reduced cardiac output is a cause of concern.

Article Info

Article Type

Research Article

Publication history

Received: Thu 22, Nov 2018
Accepted: Mon 17, Dec 2018
Published: Sun 23, Dec 2018

Copyright

© 2023 Alka Rachel John. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JICOA.2018.01.004