GraphPad Prism 7.0 (GraphPad Software Inc., La Jolla, CA) was used for statistical analyses. All procedures involving animals and their care were in conformity with national and international laws and policies (Art. hs‐cTnT indicates highsensitivity cardiac troponin T; NSE, neuron‐specific enolase. Nevertheless, in the early post‐resuscitation period, a consistently lower high‐sensitivity cardiac troponin T accompanied by a better ejection fraction and a lesser increased left ventricular end‐systolic volume was observed in animals subjected to mechanical CC compared with those that received manual CC (Table 3). Data are reported as mean±SEM. *P<0.05, †P<0.01 vs manual chest compression. Unauthorized More specifically, Impcc variability was similar between the 2 groups during the static condition, while it was >4‐fold greater in the manual CC group compared with the mechanical one during transport (P<0.01, Figure 4). For measurements of right atrial pressure, another fluid‐filled 7F catheter was advanced from the right femoral vein into the right atrium. If ROSC was not achieved, CPR was resumed and continued for 1 minute before a subsequent defibrillation with an escalating energy strategy (300‐360‐j). Please join us on August 21st at Hartland Glen Golf Course for a fun filled day while supporting your local firefighters!! Figure 1 On the top: a flowchart of the study protocol.

Respiratory frequency was adjusted to maintain the end‐tidal partial pressure of carbon dioxide (EtCO2) between 35 and 40 mmHg, monitored with an infrared capnometer (LIFEPAK 15 monitor/defibrillator, Physio‐Control, WA).25. In this preclinical model of CPR performed in a moving ambulance, a piston‐based mechanical CC allowed for a significantly greater hemodynamic support and systemic perfusion, as represented by higher CPP, EtCO2, and arterial pressure, and lower arterial lactate, compared with manual CC. CC indicates chest compression; CCF, chest compression fraction; CPR, cardiopulmonary resuscitation; Imp, impedance. The Lucas may be used in patients 12 years of age and older who have suffered cardiac arrest, where manual CPR would otherwise be used. Authors thank Dr Fredrik Arnwald Clinical Department, Stryker/Jolife AB, Lund, Sweden for having supported the proposal. Arterial lactate showed a significantly greater increase in the manual CC group compared with mechanical one during the whole CPR period (P<0.01, Figure 2). The LUCAS 3.0 CPR Chest Compression System is an incredible lifesaving device that is quickly becoming a must for any first responder's kit. Data are reported in mean±SEM, except for hs‐cTnT and NSE that are expressed as median [interquartile range]. All 8 (100%) animals in the mechanical CC group and 6 (75%) in the manual one achieved ROSC (P=0.47, Table 3). All the resuscitated animals survived for 72 hours with a complete neurological recovery, except 1 in the mechanical CC group, which died 4 hours after resuscitation as a consequence of a hypertensive pneumothorax occurring during the transfer back to the cage (Table 3). In short, the LUCAS 3 enables medical professionals to best save lives of sudden cardiac arrest and avoid neurological damage during an event by supplying a steady supply of oxygen to both the heart and the brain. For comparisons between time‐based measurements within the 2 groups, repeated‐measures analysis of variance was used. Higher right atrial pressure in the manual CC group might have been the consequence of the suboptimal CC quality provided, which produced low CO and forward blood flow. Figure 3 Systolic (SAP) and diastolic (DAP) arterial pressure, and right atrial pressure (RAP) at baseline, during cardiopulmonary resuscitation, and after return of spontaneous circulation. Lucas for LUCAS is a subsidiary of Vetter Family Organization, Inc, a registered 501(c)(3) nonprofit on a mission to provide local fire departments with LUCAS hands-free CPR devices. Out‐of‐hospital cardiac arrest is a leading cause of death worldwide.1 Despite major efforts to improve outcome, the most recent trials have provided dismal end results with only 3% to 10% of patients surviving to hospital discharge.3 Accordingly, prompt cardiopulmonary resuscitation (CPR) is the major determinant of successful resuscitation,2 but its quality heterogeneity may contribute to the variable survival rates reported in different regions.8, During CPR, provision of high‐quality chest compression (CC) may re‐establish systemic blood flow, achieving and maintaining threshold levels of coronary and cerebral perfusion.2 Nevertheless, ineffective and frequently interrupted manual CC is often provided even by well‐trained rescuers, leading to unsuccessful resuscitative efforts.12 The challenge is even greater during transport, a condition characterized by the presence of acceleration, deceleration, and rotational forces that may affect the rescuers’ performance.16 Thus, high‐quality manual CC in the moving ambulance is physically demanding and impractical, and might compromise providers’ safety.16 For this special circumstance, the use of a mechanical CPR device, capable to deliver CC consistently, has been suggested as a reasonable alternative to manual CC.16, However, the above suggestion has been supported only by manikin studies or clinical data on the quality of CPR metrics.18 Indeed, whether mechanical CPR is superior to manual CPR in special situations, such as the moving ambulance, has been highlighted as a knowledge gap in the 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science, underlying the urgency to focus research efforts on this field.16. Mechanical CC accounted also for a better CC quality, with a lesser rescuer's physical effort requirements, compared with manual compression. Similarly, EtCO2, systolic and diastolic arterial pressures were not different in the 2 groups during the static condition, while they were significantly higher in the mechanical CC compared with the manual one during ambulance transport (P<0.01, Figures 2 and 3). The hypothesis on whether mechanical CC would improve systemic perfusion compared with manual CC was tested in a preclinical porcine model of out‐of‐hospital cardiac arrest. Dr Hardig is an employee of Stryker/Jolife AB. Arterial lactate was assessed during cardiopulmonary resuscitation and after resuscitation. BE indicates base excess; HCO3, bicarbonate; PaCO2; arterial carbon dioxide partial pressure; PaO2; arterial oxygen partial pressure; PR, post‐resuscitation; SpO2, arterial oxygen saturation. All animals in the mechanical CC group and 6 (75%) in the manual one were successfully resuscitated. However, data on CC depth have been already reported in earlier studies performed on manikins, whereas no data on hemodynamics have been present yet. Shapiro–Wilk test was used to confirm normal distribution of the data. This study has several strengths. These machines are a tremendous asset to our first responders and are saving lives! A fourth investigator, seating at the head site, provided continuous timing information to the rescuers and assured compliance to the experimental protocol, without any direct intervention in the resuscitative maneuvers. Secondly, the time of untreated VF was relatively short, ie, 2 minutes, to be comparable with a real out‐of‐hospital cardiac arrest scenario and to account for a relevant myocardial ischemia.45 Nevertheless, the aim of the study was to investigate the hemodynamics during CPR in a moving ambulance, while effects on survival or long‐term outcome will be assessed in future studies using more clinically relevant durations of no‐flow.46 Thirdly, CC depth was not assessed, and thus the impact of transport on this CPR parameter can be only speculated based on the TTI signal and CPP. A possible rescuers’ leaning on the animal chest to warrant a stable position against the vehicle's movements might be another valid explanation.22, Similarly, capnography is another valuable tool to monitor the physiological effects of CPR, as it reflects pulmonary blood flow and indirectly the CC‐generated CO.7 During prolonged CPR, failure to achieve an EtCO2 >10‐15 mmHg has shown a strong correlation with unsuccessful resuscitation.35 In this study, EtCO2 achieved the above thresholds, nevertheless, it was consistently higher in the mechanical CC group compared with the manual one during transport, anticipating a greater effectiveness of CC delivered mechanically.10 Somewhat surprising, during the static condition no differences in CPP, EtCO2, and hemodynamics were detected between the 2 groups, indicating a manual CC of high quality, comparable with that of the mechanical piston device. 31, D. Lgs n° 26/2014). Adult basic life support and automated external defibrillation, A randomized trial of epinephrine in out‐of‐hospital cardiac arrest, Effect of a strategy of a supraglottic airway device vs tracheal intubation during out‐of‐hospital cardiac arrest on functional outcome: the AIRWAYS‐2 Randomized Clinical trial, Effect of a strategy of initial laryngeal tube insertion vs endotracheal intubation on 72‐hour survival in adults with out‐of‐hospital cardiac arrest: a randomized clinical trial, European resuscitation council guidelines for resuscitation 2015 section 3.
By continuing to browse this site you are agreeing to our use of cookies. During cardiopulmonary resuscitation, arterial lactate was lower with mechanical CC compared with manual CC (6.6±0.4 versus 8.2±0.5 mmol/L, P<0.01). During the initial 3 minutes of cardiopulmonary resuscitation, the ambulance was stationary, while then proceeded along a predefined itinerary. The study was supported by equipment and grants from Stryker/Jolife AB, Lund, Sweden, which did not influence to any extent any of the data analysis. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell, This is an open access article under the terms of the. 1-800-AHA-USA-1 A great effort was done to reproduce a real clinical scenario of ambulance transport with ongoing CPR in an urban area, ie, a clinical ambulance with human medical equipment and professional rescuers were used. The study results add evidence to the current knowledge gap on mechanical CPR devices as claimed in the 2015 International Consensus on CPR.16. Categorical variables were described as count and proportion (%). Lucas for LUCAS is a subsidiary of Vetter Family Organization, Inc, a registered 501(c)(3) nonprofit on a mission to provide local fire departments with LUCAS hands-free CPR devices. Frontal plane ECG was recorded. The study provides evidence to the current knowledge gap on mechanical CPR during transport as claimed in the 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Continuous variables are reported as mean±SEM or median with interquartiles [Q1–Q3], as appropriate.

These machines are a tremendous asset to our first responders and are saving lives. Mechanical CC accounted also for a better CC quality, with a lesser rescuer's physical effort requirements, compared with manual CC. CO indicates cardiac output; CPR, cardiopulmonary resuscitation; EDV, left ventricular end‐diastolic volume; EF, left ventricular ejection fraction; ESV, left ventricular end‐systolic volume; HR, heart rate; hs‐cTnT, high‐sensitivity cardiac troponin T; NSE, neuron‐specific enolase; OPC, overall performance category; PR, post resuscitation; ROSC, return of spontaneous circulation. In the following 15 minutes, the ambulance proceeded along a predefined itinerary inside the veterinarian university campus and in the surrounding area, simulating a typical urban transportation.


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