Systems and procedures for treating cardiac arrest
First Claim
1. A method for cardiopulmonary resuscitation of a person, comprising:
- providing a breathing gas under positive pressure to the airways of the person;
mechanically stimulating the person'"'"'s heart using a pneumatic drive unit to reciprocate a rod for compressing and decompressing the person'"'"'s chest while inducing the person to inspire and expire against the positive pressure of the breathing gas for at least a period of time until a positive coronary perfusion pressure develops; and
electrically stimulating the heart once the positive coronary perfusion pressure exceeds a threshold pressure, wherein the pneumatic drive unit is driven by a gas that is recycled for use as the breathing gas.
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Accused Products
Abstract
Improved procedures for cardiopulmonary resuscitation of a victim of cardiac arrest are provided. In the resuscitation, the victim'"'"'s chest is mechanically compressed and decompressed to stimulate the heart. The victim is induced to inspire and expire against insufflating breathing gas during the chest compression/decompressions. The breathing gases are adduced under pressure to promote the development of a positive coronary perfusion pressure.
Electro-stimulation of the heart can be carried after positive coronary perfusion pressures have been achieved. The electro-stimulation can be defibrillation or heart pacing or both. The chest compression/decompression cycles and the electro-stimulation measures are synchronized to promote sufficiently body circulation of oxygenated blood in a subject suffering from cardiac arrest. Medical equipment systems are provided for implementing the CPR procedures.
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Citations
74 Claims
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1. A method for cardiopulmonary resuscitation of a person, comprising:
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providing a breathing gas under positive pressure to the airways of the person; mechanically stimulating the person'"'"'s heart using a pneumatic drive unit to reciprocate a rod for compressing and decompressing the person'"'"'s chest while inducing the person to inspire and expire against the positive pressure of the breathing gas for at least a period of time until a positive coronary perfusion pressure develops; and electrically stimulating the heart once the positive coronary perfusion pressure exceeds a threshold pressure, wherein the pneumatic drive unit is driven by a gas that is recycled for use as the breathing gas. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
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26. A system for administering steps in a course of cardiopulmonary resuscitation to a person, comprising:
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a chest compression device for administering mechanical stimulation to the person'"'"'s heart using a pneumatic drive unit to reciprocate a rod for compressing and decompressing the person'"'"'s chest; a module for administering electric stimulation to the heart; a control unit for coordinating the administration of mechanical and electric stimulation to the heart over the course of the cardiopulmonary resuscitation; and means for supplying pressurized breathing gas to the person'"'"'s lungs during the course of the cardiopulmonary resuscitation, wherein the pneumatic drive unit operates on a gas, and wherein the means for supplying the pressurized breathing gas recycles the gas that is used to operate the pneumatic drive unit. - View Dependent Claims (27, 28, 29, 30, 31, 32, 33)
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34. A non-invasive method of re-establishing adequate circulation in a person under cardiac arrest comprising:
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providing a breathing gas under positive pressure to the airways of said person; mechanically stimulating the heart of said person using a pneumatic drive unit to reciprocate a rod for repeatedly compressing and decompressing the person'"'"'s chest at a rate from 60 cycles per minute to 200 cycles per minute, while making the person inspire and expire against the positive pressure of the breathing gas for a period of time sufficient to establish a positive coronary perfusion pressure; consecutively to the start of the provision of said breathing gas and said compression and decompression, providing electro-stimulation, with the proviso that the electro-stimulation is provided only consecutively to the establishment of a positive coronary blood pressure, while continuing with mechanical stimulation and provision of said positive pressure gas; and optionally repeating the steps of exclusive mechanical stimulation and mechanical stimulation concomitant with electro-stimulation, wherein the pneumatic drive unit is driven by the breathing gas, and wherein the breathing gas inspired by the person during said mechanical stimulation is substantially breathing gas consumed in driving said pneumatic drive unit. - View Dependent Claims (35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56)
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57. An apparatus for resuscitating a person under cardiac arrest comprising:
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a reciprocating means for mechanical stimulation of the heart; a means for the electric stimulation of the heart; a means for controlling the provision of mechanical and electric stimulation over time to allow electric stimulation to be provided once at least one of the following conditions has been obtained (1) the time average-mean volume of blood in the right atrium of the person at asystole has been reduced by at least 50%, (2) ventricular fibrillation has been reduced by at least 50%, (3) 20 ml or more of blood has accumulated in the left ventricle of the person, and (4) a positive coronary perfusion pressure threshold; a means for adducing breathing gas under pressure to the airways of the person; a source of compressed breathing gas for providing breathing gas to the person being resuscitated coupled with the gas adducing means; and a means for controlling the pressure of the breathing gas provided to the person, wherein the source of compressed breathing gas is designed to provide gas for driving the reciprocating means, and wherein the gas for driving the reciprocating means is the breathing gas provided to the person. - View Dependent Claims (58, 59, 60, 61, 62)
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63. An apparatus for re-establishing circulation in a person under cardiac arrest comprising:
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a source of compressed breathing gas; means for providing said breathing gas under positive pressure to the airways of the person; pneumatic reciprocating means for mechanically stimulating the heart of the person by repeatedly compressing and decompressing the chest at a rate from 60 cycles per minute to 200 cycles per minute; electrical means for providing electrostimulation to the heart of the person, wherein the compressed breathing gas is used for driving said reciprocating pneumatic means and wherein the breathing gas vented from the reciprocating pneumatic means is used for providing breathing gas under positive pressure to the airways of the person. - View Dependent Claims (64, 65, 66, 67, 68)
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69. An apparatus for resuscitating a person under cardiac arrest comprising:
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a pneumatic drive unit that reciprocates a rod for compressing and decompressing the person'"'"'s chest, wherein the pneumatic drive unit is driven by compressed breathing gas; and a detachable means for administering a portion of the breathing gas consumed for driving the drive unit to the airways of the person at a positive pressure over a time period of 1 minute or more. - View Dependent Claims (70, 71)
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72. A system for administering steps in a course of cardiopulmonary resuscitation to a person, comprising:
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a chest compression device for administering mechanical stimulation to the person'"'"'s heart; a module for administering electric stimulation to the heart; a control unit for co-ordinating the administration of mechanical and electric stimulation to the heart over the course of the cardiopulmonary resuscitation; an analysis unit for assessing the state of the person'"'"'s heart during the course of the cardiopulmonary resuscitation, wherein the control unit comprises a program for automatically modifying steps in the course of the cardiopulmonary resuscitation in response to assessments made by the analysis unit; and means for supplying pressurized breathing gas to the person'"'"'s lungs during the course of cardiopulmonary resuscitation, wherein the chest compression device is a pneumatic device operating on a gas, and wherein the means for supplying pressurized breathing gas recycles the gas used to operate the pneumatic device. - View Dependent Claims (73, 74)
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Specification