Historical Review of The Development, Technique, Safety, and Efficacy of Interposed Abdominal Compression Cardiopulmonary Resuscitation as a Promising Adjunct with Standard CPR |Biomedgrid

Interposed abdominal compression cardiopulmonary resuscitation, henceforth referred to as IAC-CPR, is an adjunct to standard CPR (S-CPR) according to American Heart Association (AHA) guidelines since 1992. Compared to other CPR adjuncts like high-frequency CPR, Active Compression Decompression CPR (ACD-CPR), vest CPR, mechanical (piston) CPR, Simultaneous Compression Decompression CPR (SCD-CPR), Phased Thoracic Abdominal Compression Decompression CPR (PTACD), and invasive CPR, IAC-CPR is widely accepted to be the least expensive, simplest, and most studied adjunct. IAC-CPR incorporates additional manual rhythmic compression of the region between the umbilicus and xiphoid process of the abdomen during the relaxation, or diastolic, phase of standard CPR (S-CPR) [1]. IAC-CPR is believed efficacious by increasing venous return to the heart through IVC compression while simultaneously providing aortic counterpressure, ultimately increasing coronary perfusion [2]. It is an oft-forgotten method of resuscitation - despite the AHA acknowledging its efficacy compared to traditional CPR, its technical difficulty as well as resource demand limits its feasibility in a critical situation. The technique itself requires 3 medical personnel trained in its use, one for airway, one for chest wall and the other for abdominal compressions. As if the demand on the number of medical staff needed weren't enough, IAC-CPR also requires precise compression timing and depth for appropriate success. Thus, the question clearly arises: why even bother? It may seem foolish to devote additional manpower and training for something that is rarely used to begin with. With that in mind, this mini-review will serve to provide a brief overview of past and present literature surrounding its promise as well as any implications this may have on the future deliverance of CPR in the Basic Life Support (BLS) protocol.