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February 12, 1982

Abdominal Binding During CPR

JAMA. 1982;247(6):752. doi:10.1001/jama.1982.03320310016006

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To the Editor.—  I wish to comment on the article entitled "Abdominal Binding During Cardiopulmonary Resuscitation in Man" (1981;246:351).I have done similar experimental trials of cardiopulmonary resuscitation (CPR) in dogs with airway ventilating pressures (80 mm Hg) while protecting the lungs from overexpansion with a tight thoracoabdominal binder. I found much simpler and faster was the use of one or two 22.6-kg sandbags.The results of Chandra et al indicate that this addition is a notable improvement over conventional CPR, since it prevents intrathoracic pressure from being dissipated on forcing down the diaphragm and protruding the abdomen. However, I found the high airway pressure not useful, since this required a high pressure in the cuff of the endotracheal tube, and this will probably damage the trachea. Nevertheless, normal airway resistance is sufficient to maintain effective pressure on the pulmonary blood pool during the half-second of chest compression.The 30-sq