Hemodynamics of active abdominal compression decompression CPR in a rat model of multiple rib fractures with asphyxial cardiac arrest

Active abdominal compression-decompression resuscitation (AACD-CPR) has been proposed as an alternative to standard cardiopulmonary resuscitation (STD-CPR) for cases of multiple rib fractures with asphyxial cardiac arrest (CA), yet its underlying hemodynamic effects remain unclear. In this study, thirty-eight rats underwent bilateral rib fracture modeling, with thirty successfully modeled and then randomly assigned to the AACD-CPR, STD-CPR, or sham groups (n = 10 each). After surgical procedures, rats experienced 8 min of asphyxia followed by assigned CPR, or no intervention in the sham group. Hemodynamic and arterial blood gas parameters were measured at multiple time points during and after resuscitation, and rates of return of spontaneous circulation (ROSC) as well as cumulative 240-minute survival were recorded. AACD-CPR resulted in lower right atrial diastolic pressure during resuscitation and less severe acidosis at 30 min post-resuscitation compared to STD-CPR, although other hemodynamic and outcome measures did not differ significantly between the two resuscitation techniques. These findings suggest that AACD-CPR can achieve similar hemodynamic performance and survival outcomes to STD-CPR in a rat model of multiple rib fractures causing asphyxial cardiac arrest, supporting its potential as an alternative when conventional chest compressions are compromised.