Why the study?
Current CPR feedback devices track mechanics but leave a gap in determining the impact of quality compressions on peripheral vascularization, blood pressure, and blood flow.
Does clamping peripheral vasculature (simulated tourniquet) increase blood pulse pressure during CPR in a vascularized mannequin model?
Does clamping peripheral vasculature (simulated tourniquet) increase blood pulse pressure during CPR in a vascularized mannequin model?
A novel vascularized CPR mannequin prototype demonstrated that simulated tourniquet application to lower limbs significantly increases mean pulse pressure during compressions.
Model enables testing of CPR hemodynamics via peripheral flow; leaves open clinical utility of ultrasound feedback during resuscitation.
Introduction : Feedback devices for cardiopulmonary resuscitation (CPR) currently register compression rate, depth, recoil and land marking. There remains a gap in determining the impact of peripheral vascularization, blood pressure, and blood flow as a result of quality CPR compressions. Methods : Our team designed a closed-loop CPR mannequin model that represented the vascularization of a human, including peripheral lower limbs. A disposable, ultrasound bandage (Flosonics Flopatch™) was applied to measure the blood flow. The model consisted of a CPR mannequin and feedback software, pressure monitoring device, patient monitor, Polyvinyl chloride (PVC) tubing and connectors, siphon bulb, 3D printed parts and wood for stabilization, Kelly clamps, and water mixture to replicate blood. A full cost breakdown and set-up is provided. Results : 28 Basic Life Saving-trained individuals tested the device both clamped and unclamped to peripheral vasculature. CPR was performed for 5 minutes at 60bpm to mimic human heart rate with siphon bulb limitations. Findings demonstrate that pulse pressure mean was 69.9mmHg clamped and 65.0mmHg unclamped (p = 0.03), consistent with expected values anticipated during effective compressions. Blood flow velocity was statistically insignificant, and cannot be inferred on due to inconsistencies with the ultrasound bandage. Conclusions: The CPR vascularization prototype was effective in replicating blood pressures of a human adult circulatory system, including peripheral vasculature. There remains limitations to state the model was effective for replicating blood flow velocity with the Flopatch™, further testing is required. The use of Kelly clamps was effective in restricting blood flow to tube sections.
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Bagha et al. (2022) studied this question.
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