Circulatory Flow Restoration Versus Cardiopulmonary Resuscitation: New Therapeutic Approach in Sudden Cardiac Arrest

Abstract

Sudden cardiac arrest (SCA) remains a major problem for health authorities worldwide. Insufficiencies of current cardiopulmonary resuscitation (CPR) are most probably related to an inappropriate concept and applied methods that still concentrate on heartbeat as priority, instead of blood circulation to maintain organs' perfusions. The aim of this works is to propose a new therapeutic approach for SCA in a more effective and secure manner compared with current CPR methods. It correlates to a non-invasive circulatory flow restoration (CFR) device composed of a multilayered thoracic and infradiaphragmatic compartments that will be pulsated alternatively and in fixed frequencies using a low-pressure pneumatic generator. Proof-of-concept studies with different prototypes and methods of SCA, showed restoration of hemodynamics (BP ≥ 100 mm Hg) and increased urine output after 20 min of cardiac arrest in pediatric dogs and piglets. In summary, a CFR device can induce shear stress-mediated endothelial function to restore microcirculation and cellular metabolism. This represents a cost-effective method, predisposes to return of spontaneous circulation in case of SCA, adaptable for all age groups, in public and hospital environments.

Endothelial Shear Stress Enhancements: A Potential Solution for Critically Ill Covid-19 Patients

“…The proposed concept was presented at the American Thoracic Society conference in 2014 [17], and based on a circulatory flow restoration device, tested in pediatric models with sudden cardiac arrest [18].…”

“…As been previously described [18], prototypes ( Fig. 4) were tested in pediatric animal models, (n° = 7 piglets and 4 puppies).…”

“…Practically, a human body (Soma) can be divided into three imaginary hemorheological spheres [18]: A, B, and C (Somarheology theory), wherein A stands for the amount of fluids, that could be compressible Newtonian (e.g., air), or incompressible non-Newtonian (e.g., blood) fluids, surrounded by B, the barriers of cells (e.g., vascular endothelium, alveolar epithelium), overlapped by C, the covering tissues (e.g., vascular vessels, parenchyma, muscles, etc.). Therefore, reduction of pulmonary vascular resistances (PVR) could be induced with a pulsatile device internally through sphere (A) and/or externally e.g., through sphere (C) to create ESS at sphere (B), and in correspondence to the Dana Point (PAH) classification [47], as depicted in (Fig.7) [17].…”

Challenges in the Field of Biomedical Devices: A Multidisciplinary Perspective

“…This Special Issue groups together some original works related to the new frontiers of development of artificial organs and medical devices with particular reference to the design and testing of new prototypes . The little steps forward presented by these papers in this issue highlight the multidisciplinary approach consisting of detecting a need from the clinic, finding a technological response, and testing it experimentally.…”

“…In the sector of “artificial heart pumps” the team of Drs. Nour and Chachques investigated a new therapeutic approach for sudden cardiac arrest (SCA) and, in particular, to the optimization of cardiopulmonary resuscitation (CPR) methods, a field of great interest from the point of view of technological innovation . To overcome the limits of current CPR, strictly focused on heartbeat, they decided to focus more on the blood circulation to maintain organs' perfusions.…”