On the essence of cardiopulmonary resuscitation

This article discusses that the essence of cardiopulmonary resuscitation (CPR) is energy transfer. The concept of occult cardiac arrest is proposed, and cardioversion after cardiac arrest is divided into spontaneous cardioversion and CPR according to the principle of energy transfer: the internal energy transmission of the body makes the cardioversion that is known as spontaneous cardioversion, and energy is mainly transfers from the outside leads to cardioversion, that is, CPR. The concept of domain energy in CPR is proposed, and it is argued that only energy transfer beyond the domain energy can lead to cardioversion in both spontaneous cardioversion and CPR. The principle of energy transfer is used to explain the common clinical electrocardiographic phenomena: dysrhythmia can occur when the energy required for the cardiac functions is insufficient, it is a manifestation of self-protection of the heart and the body, and the mechanism is further argued. It is demonstrated that serious cardiac events, such as ventricular fibrillation and cardiac arrest, are special types of cardiac self-protection. The mechanisms, general rules, and energy properties of modern CPR energy transfer are described, and the influence and interaction of energy transfer principle on the three states of time, space, and energy transfer during CPR are assessed, which will be significant for future research on CPR.