We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......

The Thoracic Pump Provides a Mechanism for Coronary Perfusion

John Michael Criley, MD
Arch Intern Med. 1995;155(11):1236. doi:10.1001/archinte.1995.00430110160018.
Text Size: A A A
Published online


Tucker et al,1 in their article entitled "Cardiopulmonary Resuscitation: Historical Perspectives, Physiology, and Future Directions" in the October 10,1994, issue of the Archives, reviewed the two physiologic theories that have been proposed to explain the mechanisms of blood flow during cardiopulmonary resuscitation (CPR): the direct cardiac compression and thoracic pump models. They concluded that both mechanisms "... are not necessarily mutually exclusive" and that "... both mechanisms may be operant,"1 sentiments with which my coworkers and I agree.

However, we take strong issue with the authors' concluding statement in the "Thoracic Pump Model" section: "... the thoracic pump model provides no mechanism at all for blood flow to the coronary circulation."1 This claim is later contradicted by their own text in the "Vest CPR" section, in which they cite "... improved coronary perfusion and survival" and "... coronary flow of 40% to 60% of normal" in dogs and


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

2 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.