Cardiopulmonary Resuscitation Using Controlled Sequential Elevation of the Head and Thorax, Active Compression-Decompression, and Impedance Threshold Device as the Future Standard of Care for Sudden Cardiac Arrest: Based on Neurological Survival Study in Porcine Models
Campus Only Senior Thesis
Bachelor of Arts
Science and Management
© 2022 Natalie M Tsai
Recent resuscitation studies have shown that the combination of controlled sequential
elevation of the head and thorax (CSE), active compression-decompression (ACD) cardiopulmonary resuscitation (CPR), and use of an impedance threshold device (ITD) has the potential to become the standard of care for sudden cardiac arrest patients. This strategy has been shown to improve cerebral blood flow in previous animal studies. Here, we investigate and gather further evidence supporting this methodology through a neurological survival study in 16 porcine models where 8 pigs were resuscitated using ACD, ITD, and CSE, while 8 pigs were resuscitated using standard methods of CPR. After 24 hours, neurological outcomes were assessed using a cerebral performance category (CPC) score, and data was analyzed using Fisher’s exact test and unpaired student’s t-test. Significant findings for the implementation of ACD, ITD, and CSE versus standard CPR include 6/8 pigs with the ACD, ITD, and CSE intervention had a CPC score of 1 or 2, while only one out of the eight pigs with the standard CPR intervention scored a CPC score of 2 (p = 0.04). Additionally, after 18 minutes of CPR, increases in the following measurements were observed (mm Hg, mean ± SD) in the ACD, ITD, and CSE group compared to the standard CPR group: coronary perfusion pressure (41 ± 24 versus 10 ± 5, p = 0.004), ETCO2 (55 ± 10 versus 21 ± 4, p < 0.001), rSO2 (32 ± 9 versus 17 ± 2, p = 0.01), aortic pressure (47 ± 24 versus 21 ± 5, p = 0.01), and mean arterial pressure (61 ± 24 versus 26 ± 7, p = 0.003). Experimental findings concluded that the ACD, ITD, CSE intervention improves neurological survival, lending support for the implementation of ACD, ITD, and CSE into future resuscitation protocols, as well as further research.
Tsai, Natalie, "Cardiopulmonary Resuscitation Using Controlled Sequential Elevation of the Head and Thorax, Active Compression-Decompression, and Impedance Threshold Device as the Future Standard of Care for Sudden Cardiac Arrest: Based on Neurological Survival Study in Porcine Models" (2022). Scripps Senior Theses. 1834.
This thesis is restricted to the Claremont Colleges current faculty, students, and staff.