Cardiopulmonary Resuscitation in Hypogravity Simulation

2021 ◽  
Vol 92 (2) ◽  
pp. 106-112
Author(s):  
Sindujen Sriharan ◽  
Gemma Kay ◽  
Jimmy C.Y. Lee ◽  
Ross D. Pollock ◽  
Thais Russomano
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Lunar Gravity ◽  
The Moon ◽  
Chest Compressions ◽  
Resuscitation Guidelines ◽  
Cpr Quality ◽  
Gender Space ◽  
External Chest Compressions ◽  
Mixed Gender ◽  
Interplanetary Travel

BACKGROUND: Limited research exists into extraterrestrial CPR, despite the drive for interplanetary travel. This study investigated whether the terrestrial CPR method can provide quality external chest compressions (ECCs) in line with the 2015 UK resuscitation guidelines during ground-based hypogravity simulation. It also explored whether gender, weight, and fatigue influence CPR quality.METHODS: There were 21 subjects who performed continuous ECCs for 5 min during ground-based hypogravity simulations of Mars (0.38 G) and the Moon (0.16 G), with Earths gravity (1 G) as the control. Subjects were unloaded using a body suspension device (BSD). ECC depth and rate, heart rate (HR), ventilation (VE), oxygen uptake (Vo2), and Borg scores were measured.RESULTS: ECC depth was lower in 0.38 G (42.9 9 mm) and 0.16 G (40.8 9 mm) compared to 1 G and did not meet current resuscitation guidelines. ECC rate was adequate in all gravity conditions. There were no differences in ECC depth and rate when comparing gender or weight. ECC depth trend showed a decrease by min 5 in 0.38 G and by min 2 in 0.16 G. Increases in HR, VE, and Vo2 were observed from CPR min 1 to min 5.DISCUSSION: The terrestrial method of CPR provides a consistent ECC rate but does not provide adequate ECC depths in simulated hypogravities. The results suggest that a mixed-gender space crew of varying bodyweights may not influence ECC quality. Extraterrestrial-specific CPR guidelines are warranted. With a move to increasing ECC rate, permitting lower ECC depths and substituting rescuers after 1 min in lunar gravity and 4 min in Martian gravity is recommended.Sriharan S, Kay G, Lee JCY, Pollock RD, Russomano T. Cardiopulmonary resuscitation in hypogravity simulation. Aerosp Med Hum Perform. 2021; 92(2):106112.

Cardiopulmonary resuscitation: the science behind the hands

Heart ◽  
2018 ◽  
Vol 104 (13) ◽  
pp. 1056-1061 ◽  
Author(s):  
Andrew W Harris ◽  
Peter J Kudenchuk
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Sudden Cardiac Arrest ◽  
Heart Association ◽  
Scientific Basis ◽  
Chest Compressions ◽  
High Quality ◽  
Physiological Basis ◽  
Successful Resuscitation ◽  
External Chest Compressions

Sudden cardiac arrest is a leading cause of death worldwide. Despite significant advances in resuscitation science since the initial use of external chest compressions in humans nearly 60 years ago, there continues to be wide variability in rates of successful resuscitation across communities. The American Heart Association (AHA) and European Resuscitation Council emphasise the importance of high-quality chest compressions as the foundation of resuscitation care. We review the physiological basis for the association between chest compression quality and clinical outcomes and the scientific basis for the AHA’s key metrics for high-quality cardiopulmonary resuscitation. Finally, we highlight that implementation of strategies that promote effective chest compressions can improve outcomes in all patients with cardiac arrest.

Evaluation of External Cardiac Massage Performance During Hypogravity Simulation

2008 ◽  
pp. 551-560 ◽  
Author(s):  
Gustavo Delmarco ◽  
Thais Russomano ◽  
Alyson Calder ◽  
Felipe Falcão ◽  
Dario F.G. Azevedo ◽  
...  
Keyword(s):  
Chest Compression ◽  
Life Support ◽  
Elbow Flexion ◽  
Female Group ◽  
The Moon ◽  
Chest Compressions ◽  
Before And After ◽  
Exploration Mission ◽  
External Chest Compressions ◽  
Planet X

Preservation of astronaut crew health during an exploration mission to the Moon or Mars will be crucial to mission success. The likelihood of a life-threatening medical condition occuring during a mission to Mars has been estimated by NASA to be 1% per year (Johnston, 1998; Johnston, Campbell, Billica, & Gilmore, 2004). Since basic life support is a vital skill in critical care medicine, plans must be in place for cardiopulmonary resuscitation in both microgravity and hypogravity (i.e., on the surface of the Moon or Mars). Following the design of a body suspension device to simulate a hypogravity environment, subjects performed external chest compressions in 1G, 0.17G (Lunar), 0.38G (Mars), and 0.7G (Planet X). Chest compression adequacy was assessed by means of rate and depth. Heart rate immediately before and after three minutes of chest compression gave a measure of rescuer fatigue. Elbow flexion was measured using an electrogoniometer in order to assess the use of arm muscles to achieve chest compressions. This study found that the mean depth (Lunar and Mars) and rate (Mars) of chest compression was below American Heart Association recommendations during hypogravity simulation in the female group. Furthermore, elbow flexion proved to be significantly greater during Lunar and Mars hypogravity simulation than that of the 1G control condition, suggesting that upper arm force may be used to counter the loss of body weight in an attempt to maintain adequate chest compression under these conditions.

Abstract 132: Cardiopulmonary Resuscitation with Chest Compressions During Sustained Inflations in a Pediatric Porcine Model - A Randomized Control Animal Trial

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Georg Schmölzer ◽  
Siddhi Patel ◽  
Seung Yeon Kim ◽  
Gyuhong Shim ◽  
Sveva Monacelli ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Cerebral Oxygenation ◽  
Spontaneous Circulation ◽  
Chest Compressions ◽  
Current Standard ◽  
Arterial Blood ◽  
Systemic Artery ◽  
Respiratory Parameters ◽  
Pediatric Resuscitation ◽  
Resuscitation Guidelines

Background: Pediatric resuscitation guidelines recommend continuous chest compressions (CC) with asynchronized ventilation (CCaV) during cardiopulmonary resuscitation (CPR) once an airway has been secured. However, the optimal CC technique remains unknown. Aim: To determine if CCs during sustained inflations (SI) improves return of spontaneous circulation (ROSC) of asphyxiated pediatric piglets compared to CCaV. Intervention and measurements: Piglets (age 20-23 days) were anesthetized, intubated, instrumented, and asphyxiated. Protocolized resuscitation was initiated when mean arterial blood pressure was <25mmHg with bradycardia. Piglets (n=12/group) were randomized to receive CCaV resuscitation (CCaV group) according to the current resuscitation guidelines, or CC during SI (CC+SI group). The CC+SI group received a SI with a peak inflating pressure of 25 cmH 2 O for 30sec, CCs were provided at a rate of 100/min, and SI was interrupted after 30 sec for one second before a further 30sec SI was provided. CC and SI were continued until ROSC. Respiratory parameters, carotid blood flow, systemic artery pressures, and cerebral oxygenation were measured. Main results: Median (IQR) time to ROSC was significantly decreased in the CC+SI group compared to CCaV with 248 (41-346)sec vs. 720 (167-720)sec (p=0.049), respectively. CC+SI had a 100% higher rate of ROSC compared to CCaV with 10(83%) vs. 5(42%) (p=0.089), respectively. Piglets in the CC+SI group received a median (IQR) 3.5 (0-5.8) intravenous epinephrine boluses compared to 8.0 (1.8-11) in the CCaV group (p=0.123). Conclusions: Combining CC and SI significantly improved time to ROSC and survival in asphyxiated pediatric piglets when compared to the current standard of CCs with CCaV during pediatric CPR.

scholarly journals Impact of Application of Multifunction Electrode (MFE) Pads on Cardiopulmonary Resuscitation Quality

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Radosław Zalewski ◽  
Mateusz Puślecki ◽  
Łukasz Szarpak ◽  
Tomasz Kłosiewicz ◽  
Marek Dąbrowski ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Sudden Cardiac Arrest ◽  
Flow Time ◽  
Early Defibrillation ◽  
Chest Compressions ◽  
Airway Patency ◽  
Emergency Team ◽  
Simulation Based ◽  
Cpr Quality

Background. Early defibrillation and high-quality chest compressions are crucial in treatment of sudden cardiac arrest (SCA) subjects. The aim of this study was to assess an impact of defibrillation methods on cardiopulmonary resuscitation (CPR) quality. Methods. A randomized simulation cross-study was designed, in which 100 two-person paramedical teams participated. Two 10-minute scenarios of SCA in the mechanism of ventricular fibrillation were analysed. In the first one, teams had at their disposal defibrillator with hard paddles (group C), whereas in the second one, adhesive electrodes were used (group MFE). The CPR quality was evaluated on the basis of the chest compression parameters (rate, depth, recoil, compression fraction (CCF), and no-flow time), airways patency achievement, and successful emergency drug administration. Results. Substituting standard hard paddles with adhesive electrodes led to an increase in CCF (77% vs 73%; p < 0.05 ), higher rate of complete chest recoil, and a decrease in no-flow time (6.0 ± 1.1 vs. 7.3 ± 1.1; p < 0.001 ). The airway patency was ensured sooner in group MFE (271 ± 118 s vs. 322 ± 106 s in group C; p < 0.001 ). All teams in scenario with adhesive electrodes were able to administer two doses of adrenaline, meanwhile only 74% of them in group C ( p < 0.001 ). Moreover, in 8% of group C scenarios, paramedics did not have enough time to administer amiodarone. Conclusion. Our simulation-based analysis revealed that use of adhesive electrodes during defibrillation instead of standard hard paddles may improve the quality of CPR performed by two-person emergency team.

Abstract 261: Assessment of Area Duty Cycle in Manual Chest Compressions During Out-of-Hospital Cardiopulmonary Resuscitation

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Sofía Ruiz de Gauna ◽  
Jesus M Ruiz ◽  
Digna M González-Otero ◽  
Mikel Leturiondo ◽  
Jose J Gutiérrez ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Duty Cycle ◽  
Compression Rate ◽  
Chest Compressions ◽  
Compression Depth ◽  
Resuscitation Guidelines ◽  
Compression Cycle ◽  
Patient’S Outcome ◽  
The Right ◽  
Relationship Of

Introduction: To be compliant with resuscitation guidelines, chest compressions (CCs) should be provided at a rate between 100 and 120 min -1 and a depth between 50 and 60mm during cardiopulmonary resuscitation (CPR). However, two manual CCs coincident in rate (the inverse of duration) and depth can show very different compression waveforms (left figure: the narrower CC depicted in blue suggests a higher impulse compression/decompression pattern). We hypothesized that area duty cycle (ADC) could characterize the narrowness of manual CCs. Objective: To assess the ADC of manual CCs during out-of-hospital CPR and its relationship with rate and depth. Methods: We collected electronic recordings containing compression signals from Philips HeartStart MRx monitor-defibrillators used in 30 patients during out-of-hospital CPR. ADC was defined as the ratio between the area under the compression curve (dashed area in the right figure) and the total area of the compression cycle with maximum depth (area of the red box). For each CC, we annotated the compression duration T c , the area under the depth curve A, and the maximum compression depth D. ADC was computed as 100·A/T c ·D (%). The linear relationship of ADC with compression rate and depth was assessed. Results: A total of 66,971 CCs were annotated. Medians (5 th -95 th percentiles) for compression rate, depth and ADC were 109.9 min -1 (93.8, 133), 46.5 mm (30.1, 61.7), and 41.9% (32.1, 49.5), respectively. ADC showed a very low correlation with rate and depth, favoring ADC’s independence. For every 10 min -1 increase in rate, ADC increased 0.16%. For every 10 mm increase in depth, ADC decreased 0.5%. Conclusions: ADC metric could be used for characterizing the narrowness of manual CCs, independently of depth and rate. This finding could contribute to improve understanding of manual CPR dynamics and their influence on patient’s outcome.

scholarly journals Coastal Fishermen as Lifesavers While Sailing at High Speed: A Crossover Study

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Ramón Fungueiriño-Suárez ◽  
Roberto Barcala-Furelos ◽  
Marta González-Fermoso ◽  
Santiago Martínez-Isasi ◽  
Felipe Fernández-Méndez ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Crossover Study ◽  
High Speed ◽  
Chest Compressions ◽  
International Guidelines ◽  
Small Boat ◽  
Cpr Quality ◽  
Simulated Scenario

Purpose. Starting basic cardiopulmonary resuscitation (CPR) early improves survival. Fishermen are the first bystanders while at work. Our objective was to test in a simulated scenario the CPR quality performed by fishermen while at port and while navigating at different speeds. Methods. Twenty coastal fishermen were asked to perform 2 minutes of CPR (chest compressions and mouth-to-mouth ventilations) on a manikin, in three different scenarios: (A) at port on land, (B) on the boat floor sailing at 10 knots, and (C) sailing at 20 knots. Data was recorded using quality CPR software, adjusted to current CPR international guidelines. Results. The quality of CPR (QCPR) was significantly higher at port (43%±10) than sailing at 10 knots (30%±15; p=0.01) or at 20 knots (26%±12; p=0.001). The percentage of ventilation that achieved some lung insufflation was also significantly higher when CPR was done at port (77%±14) than while sailing at 10 knots (59%±18) or 20 knots (57%±21) (p=0.01). Conclusion. In the event of drowning or cardiac arrest on a small boat, fishermen should immediately start basic CPR and navigate at a relatively high speed to the nearest port if the sea conditions are safe.

scholarly journals Effect of the Use of Metronome Feedback on the Quality of Pediatric Cardiopulmonary Resuscitation

2021 ◽  
Vol 18 (15) ◽  
pp. 8087
Author(s):  
Dongjun Yang ◽  
Wongyu Lee ◽  
Jehyeok Oh
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Healthcare Providers ◽  
Compression Rate ◽  
Audio Feedback ◽  
Simple Method ◽  
Compression Depth ◽  
Pediatric Resuscitation ◽  
Cpr Quality

Although the use of audio feedback with devices such as metronomes during cardiopulmonary resuscitation (CPR) is a simple method for improving CPR quality, its effect on the quality of pediatric CPR has not been adequately evaluated. In this study, 64 healthcare providers performed CPR (with one- and two-handed chest compression (OHCC and THCC, respectively)) on a pediatric resuscitation manikin (Resusci Junior QCPR), with and without audio feedback using a metronome (110 beats/min). CPR was performed on the floor, with a compression-to-ventilation ratio of 30:2. For both OHCC and THCC, the rate of achievement of an adequate compression rate during CPR was significantly higher when performed with metronome feedback than that without metronome feedback (CPR with vs. without feedback: 100.0% (99.0, 100.0) vs. 94.0% (69.0, 99.0), p < 0.001, for OHCC, and 100.0% (98.5, 100.0) vs. 91.0% (34.5, 98.5), p < 0.001, for THCC). However, the rate of achievement of adequate compression depth during the CPR performed was significantly higher without metronome feedback than that with metronome feedback (CPR with vs. without feedback: 95.0% (23.5, 99.5) vs. 98.5% (77.5, 100.0), p = 0.004, for OHCC, and 99.0% (95.5, 100.0) vs. 100.0% (99.0, 100.0), p = 0.003, for THCC). Although metronome feedback during pediatric CPR could increase the rate of achievement of adequate compression rates, it could cause decreased compression depth.

scholarly journals Update on Cardiopulmonary Resuscitation Guidelines of Interest to Anesthesiologists

2011 ◽  
Vol 61 (5) ◽  
pp. 624-640
Author(s):  
Luiz Fernando dos Reis Falcão ◽  
David Ferez ◽  
José Luiz Gomes do Amaral
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Resuscitation Guidelines ◽  
Cardiopulmonary Resuscitation Guidelines

CPREzy™ improves performance of external chest compressions in simulated cardiac arrest

Resuscitation ◽  
2007 ◽  
Vol 72 (1) ◽  
pp. 100-107 ◽  
Author(s):  
Stefan K. Beckers ◽  
Max H. Skorning ◽  
Michael Fries ◽  
Johannes Bickenbach ◽  
Stephan Beuerlein ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Chest Compressions ◽  
External Chest Compressions
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