The Library
Evaluating current guidelines for cardiopulmonary resuscitation using an integrated computational model of the cardiopulmonary system
Tools
Daudre-Vignier, Clara, Bates, Declan G., Scott, Timothy E., Hardman, Jonathan G. and Laviola, Marianna (2023) Evaluating current guidelines for cardiopulmonary resuscitation using an integrated computational model of the cardiopulmonary system. Resuscitation, 186 . 109758. doi:10.1016/j.resuscitation.2023.109758 ISSN 0300-9572.
|
PDF
WRAP-evaluating-current-guidelines-cardiopulmonary-resuscitation-using-integrated-computational-model-cardiopulmonary-system-Bate-2023.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (327Kb) | Preview |
|
PDF
WRAP-evaluating-current-guidelines-cardiopulmonary-resuscitation-using-integrated-computational-model-cardiopulmonary-system-Bate-2023.pdf - Accepted Version Embargoed item. Restricted access to Repository staff only - Requires a PDF viewer. Download (646Kb) |
Official URL: http://dx.doi.org/10.1016/j.resuscitation.2023.109...
Abstract
Objective:
We aimed to use a high-fidelity computational model that captures key interactions between the cardiovascular and pulmonary systems to investigate whether current CPR protocols could potentially be improved.
Methods:
We developed and validated the computational model against available human data. We used a global optimisation algorithm to find CPR protocol parameters that optimise the outputs associated with return of spontaneous circulation in a cohort of 10 virtual subjects.
Results:
Compared with current protocols, myocardial tissue oxygen volume was more than 5 times higher, and cerebral tissue oxygen volume was nearly doubled, during optimised CPR. While the optimal maximal sternal displacement (5.5 cm) and compression ratio (51%) found using our model agreed with the current American Heart Association guidelines, the optimal chest compression rate was lower (67 compressions min-1). Similarly, the optimal ventilation strategy was more conservative than current guidelines, with an optimal minute ventilation of 1500 ml min-1 and inspired fraction of oxygen of 80%. The end compression force was the parameter with the largest impact on CO, followed by PEEP, the compression ratio and the CC rate.
Conclusions:
Our results indicate that current CPR protocols could potentially be improved. Excessive ventilation could be detrimental to organ oxygenation during CPR, due to the negative haemodynamic effect of increased pulmonary vascular resistance. Particular attention should be given to the chest compression force to achieve satisfactory CO. Future clinical trials aimed at developing improved CPR protocols should explicitly consider interactions between chest compression and ventilation parameters.
Item Type: | Journal Article | ||||||||
---|---|---|---|---|---|---|---|---|---|
Subjects: | R Medicine > RC Internal medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Engineering > Engineering | ||||||||
Library of Congress Subject Headings (LCSH): | Cardiac arrest, CPR (First aid) -- Standards, Cardiac resuscitation -- Computer simulation, Resuscitation -- Computer simulation, Computational intelligence, Resuscitation -- Mathematical models | ||||||||
Journal or Publication Title: | Resuscitation | ||||||||
Publisher: | Elsevier Ireland Ltd | ||||||||
ISSN: | 0300-9572 | ||||||||
Official Date: | May 2023 | ||||||||
Dates: |
|
||||||||
Volume: | 186 | ||||||||
Article Number: | 109758 | ||||||||
DOI: | 10.1016/j.resuscitation.2023.109758 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Date of first compliant deposit: | 8 March 2023 | ||||||||
Date of first compliant Open Access: | 9 March 2023 | ||||||||
RIOXX Funder/Project Grant: |
|
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year