A new method for the performance of external chest compressions during hypogravity simulation

Mackaill, Christina; Sponchiado, Gregori; Leite, Ana Karla Oliveira; Dias, Paola; Rosa, Michele Da; Brown, Elliot John; Lima, Júlio César de; Rehnberg, Lucas; Russomano, Thaís

doi:10.1016/j.lssr.2018.06.001

Cited by 7 publications

(12 citation statements)

References 25 publications

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“…Besides the microgravity CPR techniques mentioned above, other chest compression techniques, like the Mackaill-Russomano-technique, have been suggested for the special envirnonment of hypogravity [ 38 ].…”

Section: Scientific Background For Cpr In Microgravitymentioning

confidence: 99%

Cardiopulmonary resuscitation (CPR) during spaceflight - a guideline for CPR in microgravity from the German Society of Aerospace Medicine (DGLRM) and the European Society of Aerospace Medicine Space Medicine Group (ESAM-SMG)

Hinkelbein

Kerkhoff

Adler

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background With the “Artemis”-mission mankind will return to the Moon by 2024. Prolonged periods in space will not only present physical and psychological challenges to the astronauts, but also pose risks concerning the medical treatment capabilities of the crew. So far, no guideline exists for the treatment of severe medical emergencies in microgravity. We, as a international group of researchers related to the field of aerospace medicine and critical care, took on the challenge and developed a an evidence-based guideline for the arguably most severe medical emergency – cardiac arrest. Methods After the creation of said international group, PICO questions regarding the topic cardiopulmonary resuscitation in microgravity were developed to guide the systematic literature research. Afterwards a precise search strategy was compiled which was then applied to “MEDLINE”. Four thousand one hundred sixty-five findings were retrieved and consecutively screened by at least 2 reviewers. This led to 88 original publications that were acquired in full-text version and then critically appraised using the GRADE methodology. Those studies formed to basis for the guideline recommendations that were designed by at least 2 experts on the given field. Afterwards those recommendations were subject to a consensus finding process according to the DELPHI-methodology. Results We recommend a differentiated approach to CPR in microgravity with a division into basic life support (BLS) and advanced life support (ALS) similar to the Earth-based guidelines. In immediate BLS, the chest compression method of choice is the Evetts-Russomano method (ER), whereas in an ALS scenario, with the patient being restrained on the Crew Medical Restraint System, the handstand method (HS) should be applied. Airway management should only be performed if at least two rescuers are present and the patient has been restrained. A supraglottic airway device should be used for airway management where crew members untrained in tracheal intubation (TI) are involved. Discussion CPR in microgravity is feasible and should be applied according to the Earth-based guidelines of the AHA/ERC in relation to fundamental statements, like urgent recognition and action, focus on high-quality chest compressions, compression depth and compression-ventilation ratio. However, the special circumstances presented by microgravity and spaceflight must be considered concerning central points such as rescuer position and methods for the performance of chest compressions, airway management and defibrillation.

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Section: Scientific Background For Cpr In Microgravitymentioning

confidence: 99%

Cardiopulmonary resuscitation (CPR) during spaceflight - a guideline for CPR in microgravity from the German Society of Aerospace Medicine (DGLRM) and the European Society of Aerospace Medicine Space Medicine Group (ESAM-SMG)

Hinkelbein

Kerkhoff

Adler

et al. 2020

Scand J Trauma Resusc Emerg Med

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“…En esta técnica no existe sistema de fijación Ventajas: es sencillo de realizar; se puede practicar antes del vuelo espacial Desventajas: método poco estudiado. Originalmente diseñado para ambiente de hipogravedad (Luna o Marte) 22 Sin imagen disponible. Similar a la maniobra a horcajadas alrededor de la cintura Otro ambiente simulado de microgravedad que se ha empleado para estudiar este rubro es el medio líquido de una piscina.…”

Section: Método De Mackaill-russomano (Mr Cpr Method)unclassified

Reanimación cardiopulmonar en microgravedad y en los vuelos espaciales tripulados

Robles Rangel,

Carrillo Esper

2024

Medicina Crítica

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RESUMENEl paro cardiaco es una condición médica con elevada morbimortalidad. En un vuelo espacial puede resultar en la muerte de un miembro de la tripulación y tener el potencial de poner en alto riesgo a la misión. La Guías de Reanimación Cardiopulmonar de la Asociación Americana del Corazón y del Consejo Europeo de Reanimación incluyen una sección de situaciones especiales, pero no la reanimación cardiopulmonar en microgravedad. Varias investigaciones han estudiado diferentes técnicas de reanimación cardiopulmonar (RCP) en microgravedad, la mayoría se centran en la técnica y efectividad de las compresiones torácicas y pocas en el manejo de la vía aérea. Otros aspectos importantes de la RCP como la desfibrilación, el empleo de medicamentos y los cuidados postparo cardiaco han sido poco evaluados. La mayoría de los estudios han evaluado estas maniobras en situaciones que semejan microgravedad, como los vuelos parabólicos, el dispositivo de suspensión corporal y en sumersión. A pesar de las limitaciones, la RCP es posible en microgravedad, pero requiere de modificaciones de las guías desarrolladas a gravedad-1 y debe de considerar los retos que impone el espacio, la microgravedad per se y los vuelos espaciales. El objetivo de este trabajo es presentar los avances en las técnicas de RCP en la microgravedad. Palabras clave: espacio, vuelo espacial, microgravedad, reanimación cardiopulmonar.

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“…All four studies had a Repeated Measures Design with volunteers being their own control group. Three trials were conducted at the Microgravity Center of the Pontifical Catholic University of Rio Grande do Sul in Brazil [17][18][19], and one in the Centre for Human and Applied Physiological Sciences of the King's College in London [20].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…To calculate the counterweight needed to simulate body mass at different hypogravity levels, all authors used similar equations: Counterweight = 0.6 × Body mass-(0.6 × body mass × Simulated gravitational force/1 G) All studies examined CPR feasibility in 0.38 G simulating the gravitational force on Mars. Two studies also simulated hypogravity on the Moon with a force of 0.17 G or 0.16 G (1 G = 9.81 m/s 2 ) [17,20]. CPR was performed on standard CPR mannequins (e.g., Resusci Anne Skill Reporter, Laerdal Medical Ltd., Orpington, UK), which were modified to allow for measurement of compression depth and rate.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Guidelines and CPR protocols can be seen in Table 2. Participants were given feedback on CPR quality with LED lights indicating compression depths [17][18][19], a metronome set to an advised compression rate of 100/s [17,18], or verbal feedback by study investigators [19,20]. CPR was performed on standard CPR mannequins (e.g., Resusci Anne Skill Reporter, Laerdal Medical Ltd., Orpington, UK), which were modified to allow for measurement of compression depth and rate.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Effectiveness of CPR in Hypogravity Conditions—A Systematic Review

Overbeek

Schmitz

Rehnberg

et al. 2022

Life

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(1) Background: Cardiopulmonary resuscitation (CPR), as a form of basic life support, is critical for maintaining cardiac and cerebral perfusion during cardiac arrest, a medical condition with high expected mortality. Current guidelines emphasize the importance of rapid recognition and prompt initiation of high-quality CPR, including appropriate cardiac compression depth and rate. As space agencies plan missions to the Moon or even to explore Mars, the duration of missions will increase and with it the chance of life-threatening conditions requiring CPR. The objective of this review was to examine the effectiveness and feasibility of chest compressions as part of CPR following current terrestrial guidelines under hypogravity conditions such as those encountered on planetary or lunar surfaces; (2) Methods: A systematic literature search was conducted by two independent reviewers (PubMed, Cochrane Register of Controlled Trials, ResearchGate, National Aeronautics and Space Administration (NASA)). Only controlled trials conducting CPR following guidelines from 2010 and after with advised compression depths of 50 mm and above were included; (3) Results: Four different publications were identified. All studies examined CPR feasibility in 0.38 G simulating the gravitational force on Mars. Two studies also simulated hypogravity on the Moon with a force of 0.17 G/0,16 G. All CPR protocols consisted of chest compressions only without ventilation. A compression rate above 100/s could be maintained in all studies and hypogravity conditions. Two studies showed a significant reduction of compression depth in 0.38 G (−7.2 mm/−8.71 mm) and 0.17 G (−12.6 mm/−9.85 mm), respectively, with nearly similar heart rates, compared to 1 G conditions. In the other two studies, participants with higher body weight could maintain a nearly adequate mean depth while effort measured by heart rate (+23/+13.85 bpm) and VO2max (+5.4 mL·kg−1·min−1) increased significantly; (4) Conclusions: Adequate CPR quality in hypogravity can only be achieved under increased physical stress to compensate for functional weight loss. Without this extra effort, the depth of compression quickly falls below the guideline level, especially for light-weight rescuers. This means faster fatigue during resuscitation and the need for more frequent changes of the resuscitator than advised in terrestrial guidelines. Alternative techniques in the straddling position should be further investigated in hypogravity.

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A new method for the performance of external chest compressions during hypogravity simulation

Cited by 7 publications

References 25 publications

Cardiopulmonary resuscitation (CPR) during spaceflight - a guideline for CPR in microgravity from the German Society of Aerospace Medicine (DGLRM) and the European Society of Aerospace Medicine Space Medicine Group (ESAM-SMG)

Cardiopulmonary resuscitation (CPR) during spaceflight - a guideline for CPR in microgravity from the German Society of Aerospace Medicine (DGLRM) and the European Society of Aerospace Medicine Space Medicine Group (ESAM-SMG)

Reanimación cardiopulmonar en microgravedad y en los vuelos espaciales tripulados

Effectiveness of CPR in Hypogravity Conditions—A Systematic Review

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