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Cardiovascular Resuscitation

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Cardiovascular Resuscitation

Unable to reach the hospital in time, leads 50 percent deaths among heart patients, while some simple first aid techniques save their lives. Many of the diseases among these patients are curable and thus deaths can be prevented.

Hands only cardiopulmonary resuscitation (CPR) is the most effective technique to save the lives of patients. Every person should be trained in this technique. CPR technique can be learned just in five minutes with the help of which a person suffering from heart attack can be saved within 10 minutes.

Conventional cardiopulmonary resuscitation technique consists of chest compression and rescues breathing. Recent research demonstrates that rescue breathing may be unnecessary and potential detrimental in cases of cardiac arrest. This technique seems to improve blood circulation to your cardiac muscles by opening new pathways that circumvent the blocked arteries.

Enhanced External Counter Pulsation (EECP) is a latest technique. Enhanced external counter pulsation has positive clinical responses including reduction in angina and nitrate use, increase in exercise tolerance and enhanced quality of life. It is a noninvasive, non-surgical therapy with remarkable results in patients used as an alternative refractory measure. Formerly it was approved for the patients with chronic stable and unstable angina who are refractory to standard revascularization procedures and aggressive pharmacotherapy.

The EECP machine is composed of an air compressor, a computer console, a set of cuffs and stable table.

Enhanced External Counter Pulsation

The procedure of EECP Treatment includes

Cuffs are wrapped around both calves, lower and upper thighs and buttocks of the patient. The EECP machine inflates the cuffs with air and then deflates them which is synchronized with the patient's cardiac cycle, so that the pressure is applied sequentially from the calves to lower thighs to upper thighs and the buttocks, causing retrograde blood flow in the aorta starting in early diastole causing rise in diastolic blood pressure and increased venous return. At end of diastole, the compressed air is rapidly released from the cuffs to remove the externally applied pressure resulting in unloading of left ventricle and decreased systolic blood pressure. During every session, the blood pressure of patient is monitored by finger plethysmography. Approximetely a pressure of 250 mmHg is applied on cuffs, so that the ratio of plethysmographically measured diastolic peak pressure to systolic peak pressure should be 1·5 times or higher. The therapy require two sessions per day (each session of one hour) for 18 to 35 days.

This process improves cardiac haemodynamics, enhanced coronary blood flow, peripheral conditioning and satisfactory relief in pain. EECA is FDA approved for the treatment of stable angina pectoris, acute myocardial infarction, cardiogenic shock and congestive heart failure. However, it is contraindicated in patients with following conditions:

1. Arrythmias that interfere with triggering of EECP process

2. Haemorrhagic diathesis

3. Thrombosis of lower extremities

4. Lower extremity vaso-occlusive disease

5. Severe pulmonary hypertension

6. Severe uncontrolled hypertension

7. Aortic aneurism

8. Pregnancy


References:

Cardiovascular Disorders - Index

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