Head Up Cardiopulmonary Resuscitation Device

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，意外和突然的死亡造成了巨大的情感、心理和经济上的 每年给全美数十万个家庭和社区带来负担。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。在过去25年中 多年来，申请者已经发现和开发了新的方法、技术和设备来 增加CA术后的脑和冠状动脉血流量，改善神经功能健全的存活率。使用 在NIH SBIR支持之前，他们开发了阻抗阈值设备(ITD)，进行了动物和 临床试验，并最终获得FDA批准的手动主动加压减压 (ACD)加ITD，FDA有史以来批准的第一种增加术后存活可能性的设备 加州。尽管取得了这一进展，但还需要进一步创新，以实质性地改善成功的结果。 为了更多的美国人。这项申请的重点是一个新的发现，抬高头部和 ACD+ITD心肺复苏术中的胸部导致颅内压显著降低，而 脑部和冠状动脉的灌注压。这些发现，是由于当头部受到重力影响时 和心脏升高，有可能进一步显著增强脑部和冠状动脉的血液 流动，提高整体生存能力。拟议中的心脏骤停动物模型研究是 重点演示了概念验证，即当组合使用时，一种新的平视CPR设备 使用ACD+ITD CPR，能够显著安全地改善流向心脏和大脑的血流 有效提高CA延长动物模型的48小时存活率。我们进一步建议 评估人体工程学和人类因素与轻便的人类原型头顶相关 在专业消防员的帮助下，在人体模型和身体上安装CPR装置。这部小说和 这种方法可能会增加每年1万多名美国人的神经学上有利的存活率 这是由于重力增强的平视CPR提供了更多的血流量和更低的颅内压。

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.