The Future of CPR

I got to interview two cutting edge researchers on what CPR will look like in the next decade; their answers were fascinating.

Flow-Enhanced CPR

They discuss the use of the impedance threshold device and the active-compression/decompression device to augment flow during CPR. See the results of the ResQ trial listed below to see what this does in cardiac arrest patients.

Note: Dr. Lurie is the founder, chief medical officer, and a major shareholder of the company that manufactures these two devices. Dr. Yannopoulos has no conflicts of interest.

Reperfusion Injury Protection

Stutter CPR is giving 3 cycles of 20 seconds of compressions/ventilations, 20 seconds of pause. In pigs, this has markedly reduced the reperfusion injury when resuscitating a patient with prolonged arrest.

New Medications

Sodium nitroprusside (in addition to small doses of epi and flow-enhanced CPR) increases flow to the heart and the brain. May also blunt reperfusion injury to heart and brain. In addition adenosine and cyclosporine A may have a role as well.

Note: None of this is ready for clinical use--this may be the future, it is not the present

Want More?

* A presentation on the topic by Dr. Yannopoulos

* Read the ResQ Trial (Lancet  2011;377(9762):301–311)

Supplemental Audio

More on the ROC-Primed Trial and the ResQ Trial (MP3 File--Right Click and choose Save As)

More on Dosing and Intra-Arrest Hypothermia and Cath (MP3 File--Right Click and choose Save As)

Update

* Recent 15-minute pig cardiac arrest study provides continued evidence of ischemic post-conditioning (Resuscitation  Volume 84, Issue 8, August 2013, Pages 1143–1149)

* Review article on the physiology of CPR

This podcast is eligible for EMCrit CME

And Now to the Podcast...