Head Up Cardiopulmonary Resuscitation Device

平视心肺复苏装置

• 批准号: 9408319
• 负责人: Keith Lurie
• 金额: $ 22.49万
• 依托单位: MINNESOTA RESUSCITATION SOLUTIONS, LLC
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-17 至 2019-07-16
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9408319
• 关键词: Abdomen; Accident and Emergency department; American; Americas; Animal Model; Animals; Award; Blinded; Blood; Blood Circulation; Blood Gas Analysis; Blood flow; Brain; Brain Injuries; Cadaver; Carbon Dioxide; Cardiac; Cardiac Catheterization Procedures; Cardiopulmonary Resuscitation; Caring; Cause of Death; Cerebral perfusion pressure; Cerebrovascular Circulation; Cerebrum; Chest; Clinical; Clinical Trials; Communities; Coronary; Device Designs; Devices; Disease; Drainage procedure; Effectiveness; Emotional; Employee Strikes; Evaluation; FDA approved; Family; Family suidae; Feasibility Studies; Force of Gravity; Goals; Gold; Head; Head-Down Tilt; Heart; Heart Arrest; Heart Atrium; Hospitals; Hour; Human; Human Resources; Interruption; Intervention Studies; Intracranial Hypertension; Intracranial Pressure; Laboratories; Lower Extremity; Lung; Malignant Neoplasms; Manikins; Manuals; Measurement; Measures; Medical; Methods; Microspheres; Minnesota; Modeling; Modification; Nervous System Physiology; Neurologic; Neurological outcome; Organ; Outcome; Oxygen saturation measurement; Patients; Percussion; Perfusion; Phase; Physiological; Physiology; Positioning Attribute; Process; Pupil light reflex; Reproducibility; Research; Respiration; Resuscitation; Safety; Sepsis; Series; Shock; Small Business Innovation Research Grant; Stroke; Sudden Death; Supine Position; Survival Rate; System; Techniques; Technology; Testing; Time; Trauma; Traumatic Brain Injury; United States National Institutes of Health; Universities; Venous; Veterinarians; Work; base; blood pump; c new; clinically significant; commercialization; coronary perfusion; design; electric impedance; ergonomics; hemodynamics; improved; innovation; light weight; novel; novel strategies; pre-clinical; preclinical safety; pressure; programs; prototype; psychologic; research clinical testing; sound

Abstract Nearly 90% of patients who suffer an out-of-hospital cardiac arrest (CA) die. This leading cause of unexpected and sudden death in the US results in an enormous emotional, psychological and financial burden to hundreds of thousands of families and communities across America annually. Relative to the many potentially lethal disease states such as cancer, stroke, sepsis, and trauma, CA survival rates have barely improved since 1960 when manual standard (S) was first described. Over the past 25 years, the applicants have discovered and developed new approaches, techniques and devices to increase cerebral and coronary blood flow and improve neurologically-sound survival after CA. With prior NIH SBIR support they developed the impedance threshold device (ITD), performed animal and clinical trials, and ultimately obtained FDA approval for manual active compression decompression (ACD) plus ITD, the first device ever approved by the FDA to increase the likelihood of survival after CA. Despite this progress, further innovation is needed to substantively improve successful outcomes for more Americans. This application is focused on a new discovery that elevation of the head and thorax during ACD + ITD CPR results in a striking decrease in intracranial pressures and an increase in cerebral and coronary perfusion pressures. These findings, due to the effects of gravity when the head and heart are elevated, have the potential to significantly further enhance cerebral and coronary blood flow and improve overall survivability. The proposed research in an animal model of cardiac arrest is focused on demonstrating proof-of-concept that a new head up CPR device, when used in combination with ACD + ITD CPR, is able to significantly improve blood flow to the heart and brain safely and effectively increase 48-hour survival in an animal model of prolonged CA. We further propose to assess the ergonomics and human factors associated with a light-weight human prototypic head up CPR device in manikins and human cadavers with help of professional firefighters. This novel and approach could increase neurologically-favorable survival rates for >10,000 more Americans annually due to greater blood flow and lower intracranial pressure afforded by gravity-enhanced head up CPR.

摘要 近90%的院外心脏骤停（CA）患者死亡。这一主要原因 在美国，意外和突然的死亡会导致巨大的情感，心理和经济损失。 每年给美国成千上万的家庭和社区带来沉重的负担。相对于 许多潜在的致命疾病状态，如癌症、中风、败血症和创伤，CA存活率 自1960年首次描述手动标准（S）以来，几乎没有改进。过去25 多年来，申请人已经发现并开发了新的方法、技术和装置， 增加脑和冠状动脉血流量并改善CA后神经系统健康存活率。与 在NIH SBIR的支持下，他们开发了阻抗阈值装置（ITD），进行了动物实验， 临床试验，并最终获得FDA批准的手动主动加压减压 (ACD)再加上ITD，这是FDA批准的第一个增加术后生存可能性的设备。 约尽管取得了这一进展，但仍需要进一步创新，以实质性地改善成功的结果。 更多的美国人。该应用程序的重点是一个新的发现，即海拔的头部和 在ACD + ITD CPR期间，胸部导致颅内压显著降低， 脑和冠状动脉灌注压。这些发现，由于重力的影响，当头部 和心脏升高，有可能显着进一步增强大脑和冠状动脉血液 提高整体生存能力。在心脏骤停的动物模型中进行的拟议研究是 专注于证明一种新的头部心肺复苏设备，当结合使用时， ACD + ITD CPR能够显著改善流向心脏和大脑的血液， 有效地增加CA延长动物模型中的48小时存活率。我们进一步建议， 评估与轻型人体原型抬头相关的人体工程学和人为因素 在专业消防员的帮助下，人体模型和人类尸体上的心肺复苏装置。这本小说和 这种方法每年可以增加超过10，000名美国人的神经学有利生存率 这是因为重力增强的头上CPR提供了更大的血流量和更低的颅内压。

项目成果

Controlled sequential elevation of the head and thorax combined with active compression decompression cardiopulmonary resuscitation and an impedance threshold device improves neurological survival in a porcine model of cardiac arrest.

头部和胸部的受控顺序抬高结合主动加压减压心肺复苏和阻抗阈值装置可改善心脏骤停猪模型的神经存活率。

• DOI: 10.1016/j.resuscitation.2020.09.030
• 发表时间: 2021-01
• 期刊: Resuscitation
• 影响因子: 6.5
• 作者: Moore JC;Salverda B;Rojas-Salvador C;Lick M;Debaty G;G Lurie K
• 通讯作者: G Lurie K

Controlled progressive elevation rather than an optimal angle maximizes cerebral perfusion pressure during head up CPR in a swine model of cardiac arrest.

在心脏骤停猪模型中，控制的渐进式升高而不是最佳角度可在头部上升时脑灌注压力最大化。

• DOI: 10.1016/j.resuscitation.2020.02.023
• 发表时间: 2020-05
• 期刊: Resuscitation
• 影响因子: 6.5
• 作者: Moore JC;Salverda B;Lick M;Rojas-Salvador C;Segal N;Debaty G;Lurie KG
• 通讯作者: Lurie KG

Effect of controlled sequential elevation timing of the head and thorax during cardiopulmonary resuscitation on cerebral perfusion pressures in a porcine model of cardiac arrest.

• DOI: 10.1016/j.resuscitation.2019.12.011
• 发表时间: 2020-04
• 期刊: RESUSCITATION
• 影响因子: 6.5
• 作者: Rojas-Salvador, Carolina;Moore, Johanna C.;Salverda, Bayert;Lick, Michael;Debaty, Guillaume;Lurie, Keith G.
• 通讯作者: Lurie, Keith G.