Suction cup on a piston-based chest compression device improves coronary perfusion pressure and cerebral oxygenation during experimental cardiopulmonary resuscitation

Mälberg, Johan; Smékal, David; Marchesi, Silvia; Lipcsey, Miklós; Rubertsson, Sten

doi:10.1016/j.resplu.2022.100311

Cited by 6 publications

(7 citation statements)

References 25 publications

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“…Indeed, a recent experimental paper by Mälberg et al strongly supports this notion. [79] In 14 piglets receiving piston based mCPR with and without a suction cup, they found a negative correlation between EtCO2 and the chest compression induced tidal volume (correlation coefficient: 0.39 [95% CI 0.55, 0.16], r 2 0.22; p 0.004). Despite no additional lift above the sternum (and thus, no AD as we defined it in our study), the chest compression induced tidal volumes were consistently, but non-significantly, higher with the use of the suction cup.…”

Section: Cardiac Outputmentioning

confidence: 96%

“…[5,39,42,115] In addition, we notice a consistent avoidance of using early decompression phase pressures for coronary perfusion estimations. [79,97] Despite this, we have been unable to find any paper that investigates or validates how monitors in clinical use actually collect and present invasive blood pressures in the clinical setting.…”

Section: The "Diastolic Problem"mentioning

confidence: 99%

See 1 more Smart Citation

Tidal volume measurements via transthoracic impedance waveform characteristics: The effect of age, body mass index and gender. A single centre interventional study

Berve¹,

Irusta²,

Kramer‐Johansen³

et al. 2021

Resuscitation

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Section: Cardiac Outputmentioning

confidence: 96%

Section: The "Diastolic Problem"mentioning

confidence: 99%

Tidal volume measurements via transthoracic impedance waveform characteristics: The effect of age, body mass index and gender. A single centre interventional study

Berve¹,

Irusta²,

Kramer‐Johansen³

et al. 2021

Resuscitation

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“…In the study, the anterior posterior chest diameter difference of roughly 1.5 cm between the start and the end of CPR represents the chest collapse produced by CPR using a manual ACD-CPR device [24]. Therefore, mechanical CPR requires active decompression, such as piston-mounted suction cups or modified ACD-CPR devices, to compensate for reduced chest recoil during CPR [25,26].…”

Section: Plos Onementioning

confidence: 99%

A remote-controlled automatic chest compression device capable of moving compression position during CPR: A pilot study in a mannequin and a swine model of cardiac arrest

Suh,

Kim,

Kim

et al. 2024

PLoS ONE

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Background Recently, we developed a chest compression device that can move the chest compression position without interruption during CPR and be remotely controlled to minimize rescuer exposure to infectious diseases. The purpose of this study was to compare its performance with conventional mechanical CPR device in a mannequin and a swine model of cardiac arrest. Materials and methods A prototype of a remote-controlled automatic chest compression device (ROSCER) that can change the chest compression position without interruption during CPR was developed, and its performance was compared with LUCAS 3 in a mannequin and a swine model of cardiac arrest. In a swine model of cardiac arrest, 16 male pigs were randomly assigned into the two groups, ROSCER CPR (n = 8) and LUCAS 3 CPR (n = 8), respectively. During 5 minutes of CPR, hemodynamic parameters including aortic pressure, right atrial pressure, coronary perfusion pressure, common carotid blood flow, and end-tidal carbon dioxide partial pressure were measured. Results In the compression performance test using a mannequin, compression depth, compression time, decompression time, and plateau time were almost equal between ROSCER and LUCAS 3. In a swine model of cardiac arrest, coronary perfusion pressure showed no difference between the two groups (p = 0.409). Systolic aortic pressure and carotid blood flow were higher in the LUCAS 3 group than in the ROSCER group during 5 minutes of CPR (p < 0.001, p = 0.008, respectively). End-tidal CO2 level of the ROSCER group was initially lower than that of the LUCAS 3 group, but was higher over time (p = 0.022). A Kaplan-Meier survival analysis for ROSC also showed no difference between the two groups (p = 0.46). Conclusion The prototype of a remote-controlled automated chest compression device can move the chest compression position without interruption during CPR. In a mannequin and a swine model of cardiac arrest, the device showed no inferior performance to a conventional mechanical CPR device.

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“…One of the more ubiquitous devices is the Lund University Cardiopulmonary Assist System (LUCAS) device, which utilizes an automatic suction cup on a piston-based chest compression apparatus. The suction cup pulls the compressed chest back to the decompressed position, actively recoiling the thorax, increasing preload, particularly the preload velocity [ 17 ]. The advantage is twofold: it not only acts as an ACD but also performs compressions automatically, freeing up healthcare personnel to perform other tasks [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…The suction cup pulls the compressed chest back to the decompressed position, actively recoiling the thorax, increasing preload, particularly the preload velocity [ 17 ]. The advantage is twofold: it not only acts as an ACD but also performs compressions automatically, freeing up healthcare personnel to perform other tasks [ 17 ]. Unfortunately, the LUCAS device can be cost-prohibitive.…”

Section: Introductionmentioning

confidence: 99%

A Review of CPR Augmentation Devices

Bengio¹,

Goodwin²,

Scumpia³

2023

Cureus

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The study aims to assess cardiopulmonary resuscitation (CPR) outcomes in cardiac arrest patients when using CPR augmentation devices, such as the ZOLL ResQCPR system (Chelmsford, MA) or its components ResQPUMP and ResQPOD, which are manual active compression-decompression (ACD) device and impedance threshold device (ITD), respectively. The analysis included a Google Scholar-based literature review that took place between January 2015 and March 2023 and included recent publications with PubMed IDs or widely cited articles to assess the effectiveness of the ResQPUMP and ResQPOD or similar devices. This review also includes studies quoted by ZOLL, but those were not considered in our conclusion since the authors were employed by ZOLL. We found that in a study on human cadavers, the force of decompression increased the chest compliance of the chest wall by 30%-50% (p<0.05). Essentially, active compressiondecompression improved the return of spontaneous circulation (ROSC) with meaningful neurologic outcomes by 50% in a blinded, randomized, and controlled human trial (n=1,653; p<0.02). The main study on the ResQPOD had a controversial human data pool with one randomized and controlled study arguing for no significant difference with or without the device (n=8,718; p=0.71). However, a post hoc analysis and the reorganization of the data by CPR quality demonstrated significance (n decreased to 2,799, reported in odds ratio without specific p-values). In conclusion to the limited number of studies presented, any manual ACD device is a great alternative to standard cardiopulmonary resuscitation regarding survivability with good neurologic function and should be utilized in prehospital emergency medical services and hospital emergency departments. ITDs are still controversial but promising with more future data.

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Suction cup on a piston-based chest compression device improves coronary perfusion pressure and cerebral oxygenation during experimental cardiopulmonary resuscitation

Cited by 6 publications

References 25 publications

Tidal volume measurements via transthoracic impedance waveform characteristics: The effect of age, body mass index and gender. A single centre interventional study

Tidal volume measurements via transthoracic impedance waveform characteristics: The effect of age, body mass index and gender. A single centre interventional study

A remote-controlled automatic chest compression device capable of moving compression position during CPR: A pilot study in a mannequin and a swine model of cardiac arrest

A Review of CPR Augmentation Devices

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