Pointless Yoyo-Perfusion Mode in CPR: Potential Solutions!

Cardiac arrest (CA) is a hemostatic state only reversible via dynamics intracardiac action potentials implementing hemorheological-biochemical reactions of adequate blood volumes (BV). Undeniably exclusive electrophysiological processes that began since intrauterine life remain compromised by cardiopulmonary resuscitation (CPR). Failure of CPR to adapt these hemostatic-electrophysiological conditions as well as human cardiotorsal anatomy, and thoracic biomechanics results in a staggering number of CA mortalities worldwide. Except for mechanical circulatory support (MCS), CPR induces a pointless back-and-forth mode of perfusion that worsens the stalled metabolism. Since the heart and respiratory pump, the main generators of endothelial shear stress (ESS) that control organs microcirculation, thereby metabolism, no longer function. Accordingly, we propose ESS-induced meditators as a potential solution in CA, mechanically with pulsatile MCSs providing rapid circulatory flow restoration (CFR), regardless of return of spontaneous circulation (ROSC). And manually with a novel technique of cardiac massage inducing snaping atrial wall shear stress with adequate BV, promoting a less-traumatic ROSC. Our goal is to evaluate the therapeutic proposal through an in-depth analysis that could change the fierce strain in evolving current CPR doctrine, thus improving the dismal outcomes of CA victims.