A novel mechanical chest compressor with rapid deployment in all population cardiopulmonary resuscitation

Abstract

Cardiopulmonary resuscitation (CPR) resuscitates patients suffering from cardiac arrest. Mechanical chest compression CPR highlights the need for high CPR quality to facilitate survival and neurological recovery. However, current CPR devices cannot be used on pregnant women or infants. These devices' long re-setup times interrupt CPR and can cause cerebral ischemia. This study designed a novel device with a crank-sliding mechanism. The polar coordinate system (r, θ, z) shortened the setup time and enabled adjustment without moving the patient. We compared our device with commercial products (e.g., LUCAS-2) by quantifying the compression pressure. Control groups for manual CPR of trained physicians and untrained citizens were recruited. We used Resusci Anne products as models. Our results indicated that our design exhibited performance similar to that of LUCAS-2 in adults (557.8 vs. 623.6 mmHg, p = 0.217) and met the current CPR standard guidelines. Notably, our device is applicable to pregnant women [565 vs. 564.5 (adults) mmHg, p = 0.987] and infants [570.8 vs. 564.5 (adults) mmHg, p = 0.801] without lowering the compression quality. The overall compression quality and stability of mechanical chest compression CPR were favorable to those of manual CPR. Our device provides an innovative prototype for the next generation of CPR facilities.Out-of-hospital cardiac arrest is a global public health concern, with 420,000 cases in the United States, 275,000 cases in Europe, and 220,000 cases in Asia documented annually 1-3 . Rates of survival to hospital discharge range between 5% and 20% 2 . Survivors may experience severe neurological sequela even following receipt of sustained return of spontaneous circulation (ROSC) after cardiopulmonary resuscitation (CPR), and this increases medical costs and decreases patients' quality of life after hospital discharge. The quality of CPR is key to resuscitation success and long-term prognosis. High-quality CPR, as defined by the American Heart Association and European Resuscitation Council, involves four aspects: a high compression rate (100 to 120 per minute), sufficient compression depth (5 cm in adults and teenagers; 4 cm in infants), full chest recoil, and minimal hands-off time 4,5 . Table 1 lists CPR requirements in multiple populations.To deliver high-quality CPR, manual chest compression CPR (M-CPR) is traditionally the initial tool used for resuscitation. However, various problems with M-CPR can reduce CPR quality, including insufficient compression depth, compression rate variation and consequential low mean arterial pressure, diastolic arterial pressure, and coronary perfusion pressure 6 . Even the highest-quality M-CPR provides only 20%-30% of the usual cardiac output and thus may considerably reduce the ROSC rate or lead to negative neurological outcomes 7 .Recently, the use of mechanical chest compression CPR (Mcc-CPR) has shed light on various aspects related to CPR, including emergency medical services at scenes of accidents, transportation, and resuscitation room...

Efetividade da ressuscitação cardiopulmonar em gestantes

“…Em Sung et al (2020) o artigo discorre sobre a criação de um novo compressor mecânico de tórax com implantação rápida em toda a RCP da população, no entanto, pensando nas gestantes, a RCP com o dispositivo pode ter sua efetividade prejudicada, uma vez que esses aparelhos não podem operar inclinados. Nesse sentido, sabe-se que uma inclinação de 30° para o lado esquerdo do corpo durante a RCP facilita o retorno do sangue e pode prevenir a síndrome da veia cava inferior em mulheres grávidas com parada cardíaca.…”

“…Nesse sentido, sabe-se que uma inclinação de 30° para o lado esquerdo do corpo durante a RCP facilita o retorno do sangue e pode prevenir a síndrome da veia cava inferior em mulheres grávidas com parada cardíaca. (Sung et al, 2020).…”

Yeni bir yüksek ivmeli göğüs kompresyon cihazının tasarımı ve simülasyonu

“…Wei-Sung vd. [23], yetişkinlerde, bebeklerde ve hamile kadınlarda kullanıma uygun, kaydırıcı krank mekanizmalı, değiştirilebilir pistonlu ve değiştirilebilir kompresyon derinliğine sahip mekanik bir KPR cihazı geliştirdi. Sadani vd.…”

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

“…In addition to the CPR devices available on the market, self-developed CPR prototypes are not only cheap [ 23 , 24 ] but also allow for convenient control [ 25 , 26 , 27 , 28 ]. These researchers focus more on the usability and stability of the prototypes from a mechanical point of view when developing them, ignoring the effects acting on the human body.…”