Head Up CPR System with Integrated and Optimized Mechanical Active Compression Decompression for Improving Survival after Cardiac Arrest

摘要 该应用的总体目标是提高心脏骤停后神经系统完整的存活率 (SCA)是美国成年人死亡的主要原因。尽管有传统的（C）CPR，30万人中的<10%， 在美国，每年300，000名住院SCA患者中有<30%的患者存活， 功能我们建议开发和评估一种新的全面的头高位（HUP）心肺 心肺复苏（CPR）系统主要设计用于基本生活服务（BLS）提供者（消防队员， 护理人员）快速提供全自动CPR，包括第一次自动呼吸输送， 自动化和优化的全举主动加压减压，以增加神经系统 SCA后的完整生存和增加机组人员安全。该提案的重点是进一步发展和提供 基于我们最近的突破，为BLS团队提供创新的一体化HUP复苏系统（HRS） 在SCA过程中，使用头和胸的控制顺序抬高， 使用主动按压减压（ACD）CPR和阻抗阈值装置（ITD）。作为 在公认的猪SCA模型中证明，HUP CPR结合完全提升ACD CPR和ITD 独特地利用重力，以加强从头部和颈部，颅内下部静脉血的引流 压力，并显着增加全身和脑血流量和神经系统完整的可能性 生存HUP CPR的新临床数据也支持该应用程序的总体目标 登记研究表明，这种神经保护方法在快速部署时提供了显著的益处， 紧急医疗服务（EMS）第一响应者。此外，在全国范围内资源短缺的环管系统中， 越来越需要开发这样的技术，即最大限度地减少提供高性能所需的资源数量， 高质量的心肺复苏术，对患者的治疗效果最好，对救援人员更安全。我们建议实现这些目标 通过证明1）自动化和集成的ACD CPR和2） 自动呼吸输送到易于部署和全自动HUP CPR系统中，对于 BLS供应商，将减少心肺复苏术人员的资源需求，最重要的是，将优化机会， 对于SCA后神经系统完整的存活率。因此，具体目标是：1）确定最佳波形 在HUP期间，使用全ACD CPR来优化脑和心脏血流，并将优化的波形与 猪存活研究中的LUCAS 3.1波形，以及2）设计和制作功能性HRS原型， 该设备集成了优化的自动化全ACD CPR和自动呼吸输送。

Abstract The overall goal of this application is to improve neurologically-intact survival rates after sudden cardiac arrest (SCA), the leading cause of death in adults in the US. Despite conventional (C) CPR, <10% of 300,000 pre- hospital and <30% of 300,000 in-hospital SCA patients in the US each year survive with favorable neurological function. We propose to develop and evaluate a novel comprehensive Head Up Position (HUP) cardiopulmonary resuscitation (CPR) System designed primarily to allow Basic Life Services (BLS) providers (a fire crew without paramedics) to rapidly deliver fully automated CPR, including for the first time, automated breath delivery and automated and optimized full lift active compression decompression, to increase the likelihood of neurologically intact survival after SCA and increase crew safety. The proposal focuses on further developing and delivering an innovative all-in-one HUP resuscitation system (HRS) for BLS teams based on our most recent breakthroughs in optimizing brain perfusion during SCA using controlled sequential elevation of the head and thorax combined with Active Compression Decompression (ACD) CPR and an impedance threshold device (ITD). As demonstrated in a well-accepted porcine SCA model, HUP CPR combined with full lift ACD CPR and an ITD uniquely harnesses gravity to enhance drainage of venous blood from the head and neck, lower intracranial pressure, and markedly increase systemic and cerebral blood flow and likelihood for neurologically-intact survival. The overall objectives of this application are also supported by new clinical data from a HUP CPR Registry demonstrating this neuroprotective approach provides a striking benefit when deployed rapidly by Emergency Medical Services (EMS) first responders. Moreover, in resource-strapped EMS systems countrywide there is a growing need to develop technology that minimizes the number of resources required to deliver high quality CPR that is best for patient outcomes and safer for rescue personnel. We propose to achieve these collective objectives by demonstrating that incorporation of 1) automated and integrated ACD CPR and 2) automated breath delivery into an easy to deploy and fully automated HUP CPR system, is feasible and safe for BLS providers, will reduce CPR personnel resource requirements, and most importantly, will optimize chances for neurologically intact survival after SCA. As such, the Specific Aims are: 1) Determine the optimal waveform during HUP with full ACD CPR to optimize brain and heart blood flow and compare the optimized waveform with a LUCAS 3.1 waveform in a porcine survival study and 2) Design and prototype a functional HRS, an all-in-one device with integrated, optimized, and automated full ACD CPR and automated breath delivery.