Aim: The 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. Methods: Nine 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. Results: The 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. Conclusion: HUP 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.
|Original language||English (US)|
|Number of pages||7|
|State||Published - Nov 2018|
Bibliographical noteFunding Information:
The authors wish to thank the individuals who donated their bodies to the University of Minnesota's Anatomy Bequest Program for the advancement of education and research. The authors also thank Minnesota Resuscitation Solutions for providing the Head Up CPR device for use in these studies.
Institutional support from the University of Minnesota Departments of Emergency Medicine and Internal Medicine.
© 2018 Elsevier B.V.
Copyright 2018 Elsevier B.V., All rights reserved.
- Active compression decompression CPR
- Cardiac arrest
- Cardiopulmonary resuscitation
- Cerebral perfusion
- Head up CPR
- Human cadaver
- Impedance threshold device