Fully Automated Basic Life Services Resuscitation System to Improve Survival after Cardiac Arrest

全自动基本生活服务复苏系统可提高心脏骤停后的生存率

基本信息

批准号：
10256435
负责人：
Keith Lurie
金额：
$ 38.34万
依托单位：
MINNESOTA RESUSCITATION SOLUTIONS, LLC
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10256435
关键词：
Age Automated External Defibrillator Basic Life Support Blood Blood flow Brain COVID-19 Cadaver Cardiopulmonary Resuscitation Caring Cause of Death Cerebrovascular Circulation Cessation of life Chest Chest wall structure Clinical Clinical Data Country Development Devices Drainage procedure Emergency medical service Family suidae Fire - disasters Force of Gravity Funding Goals Hand Head Head and neck structure Heart Heart Arrest Hospitals Hour Human Human Resources Intracranial Pressure Life Manikins Mechanics Modeling Nervous System Physiology Neurologic Paramedical Personnel Patient-Focused Outcomes Patients Perfusion Phase Resources Rest Resuscitation Risk Safety Savings Seeds Services Shock Small Business Innovation Research Grant Suction Survival Rate System Technology Time Training Venous base design electric impedance feasibility testing fire fighter first responder implementation strategy improved innovation novel patient registry pre-clinical pressure prototype service providers sound ventilation

项目摘要

Abstract The overall goal of this application is to improve neurologically-intact survival rates after sudden cardiac arrest (SCA). Still a leading cause of death, <10% of the more than 600,000 SCA patients in the US each year survive with favorable neurological function. We propose to develop and evaluate a novel comprehensive Head Up (HUP) cardiopulmonary resuscitation (CPR) System designed primarily to allow Basic Life Services (BLS) providers (a fire crew without paramedics) to rapidly deliver fully automated CPR, including for the first time, automated synchronized mechanical positive pressure ventilation (PPV), to increase the likelihood of neurologically intact survival after SCA and increase crew safety. The proposal focuses on further developing and delivering an innovative all-in-one device for BLS teams based on our most recent breakthroughs in optimizing brain perfusion during SCA using controlled sequential elevation of the head and thorax in combination with the use of Active Compression Decompression (ACD) CPR and an impedance threshold device (ITD). As demonstrated in a well-accepted porcine SCA model, HUP CPR combined with ACD CPR and an ITD uniquely harnesses gravity to enhance drainage of venous blood from the head and neck, lower intracranial pressure, and markedly increase systemic and cerebral blood flow and likelihood for survival. The overall objectives of this application are also supported by new clinical data from a CPR Registry of patients receiving HUP CPR suggesting this comprehensive approach may provide the most benefit when deployed rapidly. Moreover, in resource-strapped Emergency Medical Services (EMS) systems across the country there is a growing need to develop technology that minimizes the number of resources required to deliver high quality CPR that is best for patient outcomes and safer for rescue personnel. We propose to achieve these collective objectives by demonstrating that incorporation of automated positive pressure ventilation (PPV), synchronized to the decompression phase of an easy to deploy and fully automated HUP CPR system, is feasible and safe for BLS providers, will reduce CPR personnel resource requirements, and most importantly, will optimize chances for neurologically intact survival after SCA. This combination of innovations, described herein as the SAVE CPR System, represents the combination of Synchronization, ACD+ITD, Ventilation, and Elevation. As such, the Specific Aims are: 1) Design and prototype an improved Head Up CPR device which includes automated PPV that is synchronized with the decompression phase of ACD CPR; 2) Determine if the SAVE CPR System will increase 24-hour survival with favorable brain function when implemented immediately after 10 minutes of untreated cardiac arrest compared with a delayed implementation strategy whereby SAVE is initiated after 10 minutes of untreated cardiac arrest and 8 minutes of conventional CPR to simulate Advanced Life Support (ALS) rather than BLS deployment of the SAVE CPR System; and 3) Test the feasibility of use of the SAVE CPR System by BLS providers in simulated cardiac arrest scenarios using manikins and human cadavers to determine if rescuers can rapidly deploy and utilize the SAVE System and to evaluate what potential improvements are necessary for a commercially viable version. We anticipate being able to demonstrate a) the ability to incorporate a PPV delivery device into the SAVE CPR System b) pre-clinical proof-of-concept that the SAVE CPR System will significantly improve neurologically-sound survival in pigs when deployed rapidly versus deploying the SAVE CPR System after a period of traditional conventional CPR, and c) that the SAVE CPR can be easily and rapidly applied by BLS providers.

抽象的该应用程序的总体目标是提高心脏骤停后神经完整的存活率（SCA）。仍然是导致死亡的主要原因，美国每年超过 600,000 名 SCA 患者中存活率不到 10% 具有良好的神经功能。我们建议开发和评估一种新颖的综合 Head Up (HUP) 心肺复苏 (CPR) 系统，主要设计用于提供基本生活服务 (BLS) 提供者（没有护理人员的消防队）快速提供全自动心肺复苏术，包括首次，自动同步机械正压通气 (PPV)，以增加发生以下情况的可能性 SCA 后神经系统完好无损，并提高船员安全。该提案的重点是进一步发展并根据我们在以下方面的最新突破，为 BLS 团队提供一款创新的一体式设备在 SCA 期间通过受控的顺序抬高头部和胸部来优化脑灌注结合使用主动加压减压 (ACD) CPR 和阻抗阈值装置（ITD）。正如广为接受的猪 SCA 模型所证明的那样，HUP CPR 与 ACD CPR 和 ITD 相结合独特地利用重力来增强静脉血从头颈部、下颅内的引流压力，并显着增加全身和脑血流量以及生存的可能性。整体该应用程序的目标还得到了 CPR 登记处接受治疗的患者的新临床数据的支持 HUP CPR 表明，这种综合方法在快速部署时可能会带来最大的好处。此外，在全国资源紧张的紧急医疗服务（EMS）系统中，有一个越来越需要开发技术，最大限度地减少提供高质量心肺复苏所需的资源数量这对患者的治疗效果是最好的，对救援人员来说也更安全。我们建议集体实现这些目标通过证明自动正压通气（PPV）的结合，同步实现目标易于部署且完全自动化的 HUP CPR 系统的减压阶段对于以下人员来说是可行且安全的 BLS 提供商将减少心肺复苏人员资源需求，最重要的是，将优化机会 SCA 后神经系统完整的存活率。这种创新组合在此称为 SAVE CPR 系统，代表同步、ACD+ITD、通风和高程的组合。因此，具体目标是： 1) 设计改进的平视 CPR 设备并制作原型，其中包括自动 PPV 与 ACD CPR 的减压阶段同步； 2) 确定 SAVE CPR 系统是否会 10 分钟后立即实施可提高 24 小时存活率并保持良好的大脑功能未经治疗的心脏骤停与延迟实施策略（即 10 点后启动 SAVE）的比较分钟的未经治疗的心脏骤停和 8 分钟的传统心肺复苏来模拟高级生命支持 (ALS) 而不是 BLS 部署 SAVE CPR 系统； 3) 测试使用 SAVE CPR 的可行性 BLS 提供商在模拟心脏骤停场景中使用人体模型和人体尸体来确定系统救援人员是否可以快速部署和利用 SAVE 系统并评估潜在的改进之处对于商业上可行的版本是必需的。我们期望能够展示 a) 整合的能力将 PPV 输送装置插入 SAVE CPR 系统 b) SAVE CPR 系统的临床前概念验证与部署 SAVE 相比，快速部署将显着提高猪的神经健康存活率经过一段时间的传统常规 CPR 后的 CPR 系统，以及 c) SAVE CPR 可以轻松快速地由 BLS 提供商应用。