• Johanna C Moore, Joe Holley, Nicolas Segal, Michael C Lick, José Labarère, Ralph J Frascone, Kenneth W Dodd, Aaron E Robinson, Charles Lick, Lauren Klein, Andrew Ashton, Angela McArthur, Adamantios Tsangaris, Anna Makaretz, Mike Makaretz, Guillaume Debaty, Paul E Pepe, and Keith G Lurie.
• Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, USA; Minneapolis Medical Research Foundation, Minneapolis, MN, USA. Electronic address: johanna.moore@hcmed.org.
• Resuscitation. 2018 Nov 1; 132: 133-139.

AimThe objectives were: 1) replicate key elements of Head Up (HUP) cardiopulmonary resuscitation (CPR) physiology in a traditional swine model of ventricular fibrillation (VF), 2) compare HUP CPR physiology in pig cadavers (PC) to the VF model 3) develop a new human cadaver (HC) CPR model, and 4) assess HUP CPR in HC.MethodsNine female pigs were intubated, and anesthetized. Venous, arterial, and intracranial access were obtained. After 6 min of VF, CPR was performed for 2 min epochs as follows: Standard (S)-CPR supine (SUP), Active compression decompression (ACD) CPR + impedance threshold device (ITD-16) CPR SUP, then ACD + ITD HUP CPR. The same sequence was performed in PC 3 h later. In 9 HC, similar vascular and intracranial access were obtained and CPR performed for 1 min epochs using the same sequence as above.ResultsThe mean cerebral perfusion pressure (CerPP, mmHg) was 14.5 ± 6 for ACD + ITD SUP and 28.7 ± 10 for ACD + ITD HUP (p = .007) in VF, -3.6 ± 5 for ACD + ITD SUP and 7.8 ± 9 for ACD + ITD HUP (p = .007) in PC, and 1.3 ± 4 for ACD + ITD SUP and 11.3 ± 5 for ACD + ITD HUP (p = .007) in HC. Mean systolic and diastolic intracranial pressures (ICP) (mmHg) were significantly lower in the ACD + ITD HUP group versus the ACD + ITD SUP group in all three CPR models.ConclusionHUP CPR decreased ICP while increasing CerPP in pigs in VF as well as in PC and HC CPR models. This first-time demonstration of HUP CPR physiology in humans provides important implications for future resuscitation research and treatment.Copyright © 2018 Elsevier B.V. All rights reserved.

27 keywords...

hide…