Increased cortical cerebral blood flow with LUCAS; a new device for mechanical chest compressions compared to standard external compressions during experimental cardiopulmonary resuscitation

Rubertsson, Sten; Karlsten, Rolf

doi:10.1016/j.resuscitation.2004.12.006

Cited by 184 publications

(79 citation statements)

References 17 publications

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“…Concerning pig models, certain authors have reported that mechanical chest compression, whatever the device, provides better coronary and thus myocardial perfusion and a greater probability of ROSC [22,23]. The same conclusions have been drawn in studies on cerebral perfusion or on cerebral blood low, and perfusion pressures recorded in the internal carotid were greater with mechanical methods than with the manual method [24]. In a pig model, blood low recorded in the left internal carotid was signi icantly greater with LUCAS ® than with manual CPR [25].…”

Section: Discussionmentioning

confidence: 68%

Comparative Hemodynamic Evaluation of the LUCAS® Device and Manual Chest Compression in Patients with Out-of-Hospital Cardiac Arrest

Mirek¹

2017

J Clin Intensive Care Med

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Section: Discussionmentioning

confidence: 68%

Comparative Hemodynamic Evaluation of the LUCAS® Device and Manual Chest Compression in Patients with Out-of-Hospital Cardiac Arrest

Mirek¹

2017

J Clin Intensive Care Med

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“…The relatively higher survival rate in studies II and III in comparison with the above studies might also be related to the improved quality of chest compressions that were performed with the LUCAS device. It was demonstrated in our group that chest compressions with the LUCAS device during experimental resuscitation resulted in higher cerebral blood flow and cardiac output than standard manual external chest compressions [165]. In animal studies, superior survival rates with drugs have been demonstrated in comparison with humans, probably due to the fact that drug administration occurs some 10 min earlier in humans than in animal studies [166].…”

Section: The Experimental Model Of Cprmentioning

confidence: 88%

Cerebral protection in experimental cardiopulmonary resuscitation (with special reference to the effects of methylene blue)

Miclescu¹

2010

Acta Anaesthesiol Scand

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Although survival rates are increasing, brain injury continues to be a leading cause of death after cardiac arrest (CA). Permanent brain damage after CA is determined by limited tolerance to ischemia from CA and cardiopulmonary resuscitation (CPR), as well as the unique cerebral response to reperfusion after return of spontaneous circulation (ROSC). A major pathway leading to neurotoxic cascade and neuronal injury after CA involves the increased presence of reactive oxygen and nitrogen species generated during ischemia and reperfusion. The magnitude of cerebral oxidative injury induced by free radicals increased with the duration of CA (Paper I). Nitric oxide (NO), a free radical responsible for the formation of reactive nitrogen species, is increased during global ischemia from CA and reperfusion (Paper IV). Hypothetically, the administration of a drug that counteracts the overproduction of NO and also acts as a scavenger of oxygen free radicals might be warranted in order to reduce the damage caused by nitrosative and oxidative stress. For these purposes we used methylene blue (MB), an old dye that has been used in medicine for almost half a century, and an experimental pig model of 20 min of ventricular fibrillation (VF) to reflect a clinical scenario of ischemia/reperfusion injury. Administration of MB added to a hypertonic-hyperoncotic solution (MBHSD) that was started during CPR and continued for 50 min after ROSC increased short-term survival by decreasing myocardial damage, as well as cerebral peroxidation and inflammatory injury (Paper II). Immunostaining of cerebral tissue collected at different time points after CA and ROSC (Paper IV) provided experimental evidence that cortical blood-brain barrier (BBB) disruption begins as early as during the initial phase of untreated as well as treated CA. The results indicated that MB administration reduced the neurologic injury and BBB disruption considerably, but did not reverse the ongoing detrimental processes. The demonstrated positive effects of MB were related to a decrease of nitrite/nitrate tissue content, and thus to a decrease of excess NO due to the MB inhibitory effects on NOS isoforms. A mixture of MB in hypertonic sodium lactate (MBL) was investigated to facilitate administration of MB in "the field." Based on findings that MBL cardio-and neuroprotective properties were similar to those of MBHSD, there is reason to believe that the use of MBL might be extended during ongoing CPR and after ROSC (Paper III). It would therefore make sense to try using MB as a pharmacological neuroprotectant during or after clinical CPR in order to expand the temporal therapeutic window before other measures for neuroprotection such as hypothermia are available. Keywords: Cardiac arrest, cardiopulmonary resuscitation, reperfusion injury, methylene blue, nitric oxide, nitric oxide synthases, blood-brain barrier

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“…(9) The other commonly used mechanical CPR device is the LUCAS (Lund University Cardiopulmonary Assist System; Jolife AB, Lund, Sweden), which has been tested in laboratory-based animal and human experiments. (10)(11)(12) These studies demonstrated higher cardiac output, carotid artery blood fl ow, end-tidal carbon dioxide, aortic and coronary perfusion pressures, and ROSC rates with mechanical rather than manual CPR, although both were initiated at about the same time. The LUCAS device has also been used effectively during performance of advanced resuscitation techniques.…”

Section: Introductionmentioning

confidence: 94%

Prompt use of mechanical cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the MECCA study report

Anantharaman¹,

Ng²,

Ang³

et al. 2017

smedj

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INTRODUCTION Early use of mechanical cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) may improve survival outcomes. Current evidence for such devices uses outcomes from an intention-to-treat (ITT) perspective. We aimed to determine whether early use of mechanical CPR using a LUCAS 2 device results in better outcomes.METHODS A prospective, randomised, multicentre study was conducted over one year with LUCAS 2 devices in 14 ambulances and manual CPR in 32 ambulances to manage OHCA. The primary outcome was return of spontaneous circulation (ROSC). Secondary outcomes were survival at 24 hours, discharge from hospital and 30 days. CONCLUSION This study showed a survival benefi t with LUCAS CPR as compared to manual CPR only, when the device was applied early on-site. RESULTS

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Increased cortical cerebral blood flow with LUCAS; a new device for mechanical chest compressions compared to standard external compressions during experimental cardiopulmonary resuscitation

Cited by 184 publications

References 17 publications

Comparative Hemodynamic Evaluation of the LUCAS® Device and Manual Chest Compression in Patients with Out-of-Hospital Cardiac Arrest

Comparative Hemodynamic Evaluation of the LUCAS® Device and Manual Chest Compression in Patients with Out-of-Hospital Cardiac Arrest

Cerebral protection in experimental cardiopulmonary resuscitation (with special reference to the effects of methylene blue)

Prompt use of mechanical cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the MECCA study report

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