Corpuls cpr resuscitation device generates superior emulated flows and pressures than LUCAS II in a mechanical thorax model

Mathematical Model of Blood Circulation with Compression of the Prototype's Mechanical CPR Waveform

The waveform of chest compressions directly affects the blood circulation of patients with cardiac arrest. Currently, few pieces of research have focused on the influence of the cardiopulmonary resuscitation (CPR) device's mechanical waveform on blood circulation. This study investigates the effect of the mechanical waveform from a novel CPR prototype on blood circulation and explores the optimal compression parameters of the mechanical waveform to optimize blood circulation. A novel CPR prototype was designed and built to establish a kinetic model during compressions. The prototype's mechanical waveforms at various operating conditions were obtained for comparison with manual waveforms and the investigation of the optimal compression parameters. The novel CPR prototype can complete chest compressions quickly and stably. The cardiac output (CO), coronary perfusion pressure (CPP), and cerebral flow (CF) obtained by mechanical waveform compressions (1.22367 ± 0.00942 L/min, 30.95083 ± 0.24039 mmHg, 0.31992 ± 0.00343 L/min, respectively) were significantly better than those obtained by manual waveform compressions (1.10783 ± 0.03601 L/min, 21.39210 ± 1.42771 mmHg, 0.29598 ± 0.01344 L/min, respectively). With the compression of the prototype, the blood circulation can be optimized at the compression depth of 50 mm, approximately 0.6 duty cycle, and approximately 110 press/min, which is of guiding significance for the practical use of CPR devices to rescue patients with cardiac arrest.

Standardized post-resuscitation damage assessment of two mechanical chest compression devices: a prospective randomized large animal trial

BACKGROUND

Mechanical chest compression devices are accepted alternatives for cardiopulmonary resuscitation (CPR) under specific circumstances. Current devices lack prospective and comparative data on their specific cardiovascular effects and potential for severe thoracic injuries.

OBJECTIVES

To compare CPR effectiveness and thoracic injuries of two mechanical chest compression devices in pigs.

STUDY DESIGN

Prospective randomised trial.

ANIMALS

Eighteen male German landrace pigs.

METHODS

Ventricular fibrillation was induced in anaesthetised and instrumented pigs and the animals were randomised into two intervention groups. Mechanical CPR was initiated by means of LUCAS™ 2 (mCCD1) or Corpuls™ cpr (mCCD2) device. Advanced life support was applied for a maximum of 10 cycles and animals achieving ROSC were monitored for 8 h. Ventilation/perfusion measurements were performed and blood gas analyses were taken. Thoracic injuries were assessed via a standardised damage score.

RESULTS

Five animals of the mCCD1 group and one animal of the mCCD2 group achieved ROSC (p = 0.048). Only the mCCD1 animals survived until the end of the monitoring period (p < 0.01). MCCD1 animals showed less pulmonary shunt (p = 0.025) and higher normal V/Q (p = 0.017) during CPR. MCCD2 animals showed significantly more severe thoracic injuries (p = 0.046).

CONCLUSION

The LUCAS 2 device shows superior resuscitation outcomes and less thoracic injuries compared to Corpuls cpr when used for experimental CPR in juvenile pigs. Researchers should be aware that different mCCDs for experimental studies may significantly influence the respective outcome of resuscitation studies and affect comparability of different trials. Controlled human and animal CPR studies and a standardised post-resuscitation injury evaluation could help to confirm potential hazards.

TRIAL REGISTRATION

Trial approval number: G16-1-042-E4.

Military application of mechanical CPR devices: a pressing requirement?

Maintaining high-quality chest compressions during cardiopulmonary resuscitation following cardiac arrest presents a challenge. The currently available mechanical CPR (mCPR) devices are described in this review, coupled with an analysis of the evidence pertaining to their efficacy. Overall, mCPR appears to be at least equivalent to high-quality manual CPR in large trials. There is potential utility for mCPR devices in the military context to ensure uninterrupted quality CPR following a medical cardiac arrest. Particular utility may be in a prohibitive operational environment, where manpower is limited or where timelines to definitive care are stretched resulting in a requirement for prolonged resuscitation. mCPR can also act as a bridge to advanced endovascular resuscitation techniques should they become more mainstream therapy.

Corpuls CPR Generates Higher Mean Arterial Pressure Than LUCAS II in a Pig Model of Cardiac Arrest

According to the European Resuscitation Council guidelines, the use of mechanical chest compression devices is a reasonable alternative in situations where manual chest compression is impractical or compromises provider safety. The aim of this study is to compare the performance of a recently developed chest compression device (Corpuls CPR) with an established system (LUCAS II) in a pig model. Methods. Pigs (n = 5/group) in provoked ventricular fibrillation were left untreated for 5 minutes, after which 15 min of cardiopulmonary resuscitation was performed with chest compressions. After 15 min, defibrillation was performed every 2 min if necessary, and up to 3 doses of adrenaline were given. If there was no return of spontaneous circulation after 25 min, the experiment was terminated. Coronary perfusion pressure, carotid blood flow, end-expiratory CO₂, regional oxygen saturation by near infrared spectroscopy, blood gas, and local organ perfusion with fluorescent labelled microspheres were measured at baseline and during resuscitation. Results. Animals treated with Corpuls CPR had significantly higher mean arterial pressures during resuscitation, along with a detectable trend of greater carotid blood flow and organ perfusion. Conclusion. Chest compressions with the Corpuls CPR device generated significantly higher mean arterial pressures than compressions performed with the LUCAS II device.