Mathematical Modeling of Cardiopulmonary Resuscitation

2015 ◽  
Author(s):  
Ali Jalali ◽  
Robert A. Berg ◽  
Vinay M. Nadkarni ◽  
C. Nataraj
Keyword(s):  
Mathematical Modeling ◽  
Mechanical Properties ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Nonlinear Model ◽  
Optimization Technique ◽  
Nonlinear Damping ◽  
Complex Behavior ◽  
Proposed Model ◽  
Compression Data

The cardiopulmonary resuscitation procedure (CPR) is a widely used procedure for resuscitating cardiac arrest patients. Many physiological aspects of the procedure are not yet well understood. The first step for understanding and modeling such a complicated procedure is to develop an accurate model of mechanical properties of the chest during CPR. In this paper we propose a novel nonlinear model of the chest that captures the complex behavior of the chest during CPR. The proposed model consists of nonlinear elasticity and nonlinear damping along with frequency dependent hysteresis. We use an optimization technique to estimate the model coefficients for force-compression data collected from careful experiments conducted on swine. The results show excellent agreement.

Simulation of the mechanical properties of a physiological tissue

SIMULATION ◽  
1970 ◽  
Vol 14 (5) ◽  
pp. 221-224 ◽  
Author(s):  
K. Sakata ◽  
G. Parfitt ◽  
K.L. Pinder
Keyword(s):  
Experimental Data ◽  
Mechanical Properties ◽  
Mechanical Model ◽  
Cyclic Stress ◽  
Complex Behavior ◽  
Compressive Behavior ◽  
Proposed Model ◽  
Fatigue Data ◽  
Stress Fatigue

The compressive behavior of a particular physiological tissue — sheepskin — was simulated on an analog com puter, the simulation being derived from a nonlinear me chanical model. The mechanical model, which consisted of elastic, viscoelastic, and ratchet or contractile elements, was developed from cyclic-stress fatigue data. By compar ing experimental data with the simulated results, it is shown that the proposed model satisfactorily describes the complex behavior of the tissue.

scholarly journals Impact of cardiopulmonary resuscitation on a cannot intubate, cannot oxygenate condition: a randomised crossover simulation research study of the interaction between two algorithms

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030430
Author(s):  
Thomas Ott ◽  
Jascha Stracke ◽  
Susanna Sellin ◽  
Marc Kriege ◽  
Gerrit Toenges ◽  
...  
Keyword(s):  
Decision Making ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Primary Outcome ◽  
Research Study ◽  
University Hospital ◽  
Simulated Patients ◽  
Stressful Situation ◽  
Simulation Research ◽  
Simulation Centre

ObjectivesDuring a ‘cannot intubate, cannot oxygenate’ situation, asphyxia can lead to cardiac arrest. In this stressful situation, two complex algorithms facilitate decision-making to save a patient’s life: difficult airway management and cardiopulmonary resuscitation. However, the extent to which competition between the two algorithms causes conflicts in the execution of pivotal treatment remains unknown. Due to the rare incidence of this situation and the very low feasibility of such an evaluation in clinical reality, we decided to perform a randomised crossover simulation research study. We propose that even experienced healthcare providers delay cricothyrotomy, a lifesaving approach, due to concurrent cardiopulmonary resuscitation in a ‘cannot intubate, cannot oxygenate’ situation.DesignDue to the rare incidence and dynamics of such a situation, we conducted a randomised crossover simulation research study.SettingWe collected data in our institutional simulation centre between November 2016 and November 2017.ParticipantsWe included 40 experienced staff anaesthesiologists at our tertiary university hospital centre.InterventionThe participants treated two simulated patients, both requiring cricothyrotomy: one patient required cardiopulmonary resuscitation due to asphyxia, and one patient did not require cardiopulmonary resuscitation. Cardiopulmonary resuscitation was the intervention. Participants were evaluated by video records.Primary outcome measuresThe difference in ‘time to ventilation through cricothyrotomy’ between the two situations was the primary outcome measure.ResultsThe results of 40 participants were analysed. No carry-over effects were detected in the crossover design. During cardiopulmonary resuscitation, the median time to ventilation was 22 s (IQR 3–40.5) longer than that without cardiopulmonary resuscitation (p=0.028), including the decision-making time.ConclusionCricothyrotomy, which is the most crucial treatment for cardiac arrest in a ‘cannot intubate, cannot oxygenate’ situation, was delayed by concurrent cardiopulmonary resuscitation. If cardiopulmonary resuscitation delays cricothyrotomy, it should be interrupted to first focus on cricothyrotomy.

Management of out-of hospital cardiac arrest patients with extracorporeal cardiopulmonary resuscitation in 2021

2021 ◽  
pp. 1-10
Author(s):  
Christopher Gaisendrees ◽  
Matias Vollmer ◽  
Sebastian G Walter ◽  
Ilija Djordjevic ◽  
Kaveh Eghbalzadeh ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Hospital Cardiac Arrest

scholarly journals Cardiac arrest complicating cardiogenic shock: from pathophysiological insights to Impella-assisted cardiopulmonary resuscitation in a pheochromocytoma-induced Takotsubo cardiomyopathy—a case report

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Filippo Zilio ◽  
Simone Muraglia ◽  
Roberto Bonmassari
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Left Ventricle ◽  
Cardiogenic Shock ◽  
Takotsubo Cardiomyopathy ◽  
Perfusion Pressure ◽  
Coronary Perfusion Pressure ◽  
Left Ventricular ◽  
Coronary Perfusion ◽  
Refractory Cardiac Arrest

Abstract Background A ‘catecholamine storm’ in a case of pheochromocytoma can lead to a transient left ventricular dysfunction similar to Takotsubo cardiomyopathy. A cardiogenic shock can thus develop, with high left ventricular end-diastolic pressure and a reduction in coronary perfusion pressure. This scenario can ultimately lead to a cardiac arrest, in which unloading the left ventricle with a peripheral left ventricular assist device (Impella®) could help in achieving the return of spontaneous circulation (ROSC). Case summary A patient affected by Takotsubo cardiomyopathy caused by a pheochromocytoma presented with cardiogenic shock that finally evolved into refractory cardiac arrest. Cardiopulmonary resuscitation was performed but ROSC was achieved only after Impella® placement. Discussion In the clinical scenario of Takotsubo cardiomyopathy due to pheochromocytoma, when cardiogenic shock develops treatment is difficult because exogenous catecholamines, required to maintain organ perfusion, could exacerbate hypertension and deteriorate the cardiomyopathy. Moreover, as the coronary perfusion pressure is critically reduced, refractory cardiac arrest could develop. Although veno-arterial extra-corporeal membrane oxygenation (va-ECMO) has been advocated as the treatment of choice for in-hospital refractory cardiac arrest, in the presence of left ventricular overload a device like Impella®, which carries fewer complications as compared to ECMO, could be effective in obtaining the ROSC by unloading the left ventricle.

scholarly journals Towards Recognition of Scale Effects in a Solid Model of Lattices with Tensegrity-Inspired Microstructure

Solids ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 50-59
Author(s):  
Wojciech Gilewski ◽  
Anna Al Sabouni-Zawadzka
Keyword(s):  
Mechanical Properties ◽  
Continuum Model ◽  
Scale Effects ◽  
Theory Of Elasticity ◽  
Solid Model ◽  
Gradient Theory ◽  
General Description ◽  
Normal Forces ◽  
Second Gradient ◽  
Proposed Model

This paper is dedicated to the extended solid (continuum) model of tensegrity structures or lattices. Tensegrity is defined as a pin-joined truss structure with an infinitesimal mechanism stabilized by a set of self-equilibrated normal forces. The proposed model is inspired by the continuum model that matches the first gradient theory of elasticity. The extension leads to the second- or higher-order gradient formulation. General description is supplemented with examples in 2D and 3D spaces. A detailed form of material coefficients related to the first and second deformation gradients is presented. Substitute mechanical properties of the lattice are dependent on the cable-to-strut stiffness ratio and self-stress. Scale effect as well as coupling of the first and second gradient terms are identified. The extended solid model can be used for the evaluation of unusual mechanical properties of tensegrity lattices.

Does Targeted Temperature Management Improve Neurological Outcome in Extracorporeal Cardiopulmonary Resuscitation (ECPR)?

2021 ◽  
pp. 088506662110189
Author(s):  
Merry Huang ◽  
Aaron Shoskes ◽  
Migdady Ibrahim ◽  
Moein Amin ◽  
Leen Hasan ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Targeted Temperature Management ◽  
Temperature Management ◽  
Survival Outcomes ◽  
Pool Data ◽  
Good Neurological Outcome ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Over Time

Purpose: Targeted temperature management (TTM) is a standard of care in patients after cardiac arrest for neuroprotection. Currently, the effectiveness and efficacy of TTM after extracorporeal cardiopulmonary resuscitation (ECPR) is unknown. We aimed to compare neurological and survival outcomes between TTM vs non-TTM in patients undergoing ECPR for refractory cardiac arrest. Methods: We searched PubMed and 5 other databases for randomized controlled trials and observational studies reporting neurological outcomes or survival in adult patients undergoing ECPR with or without TTM. Good neurological outcome was defined as cerebral performance category <3. Two independent reviewers extracted the data. Random-effects meta-analyses were used to pool data. Results: We included 35 studies (n = 2,643) with the median age of 56 years (interquartile range [IQR]: 52-59). The median time from collapse to ECMO cannulation was 58 minutes (IQR: 49-82) and the median ECMO duration was 3 days (IQR: 2.0-4.1). Of 2,643, 1,329 (50.3%) patients received TTM and 1,314 (49.7%) did not. There was no difference in the frequency of good neurological outcome at any time between TTM (29%, 95% confidence interval [CI]: 23%-36%) vs. without TTM (19%, 95% CI: 9%-31%) in patients with ECPR ( P = 0.09). Similarly, there was no difference in overall survival between patients with TTM (30%, 95% CI: 22%-39%) vs. without TTM (24%, 95% CI: 14%-34%) ( P = 0.31). A cumulative meta-analysis by publication year showed improved neurological and survival outcomes over time. Conclusions: Among ECPR patients, survival and neurological outcome were not different between those with TTM vs. without TTM. Our study suggests that neurological and survival outcome are improving over time as ECPR therapy is more widely used. Our results were limited by the heterogeneity of included studies and further research with granular temperature data is necessary to assess the benefit and risk of TTM in ECPR population.

Beyond Extracorporeal Cardiopulmonary Resuscitation: Systems of Care Supporting Cardiac Arrest Patients

2021 ◽  
pp. 1-6
Author(s):  
Nicholas George ◽  
Alexandra Lawler ◽  
Ian Leong ◽  
Ankur A. Doshi ◽  
Francis X. Guyette ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Systems Of Care ◽  
Extracorporeal Cardiopulmonary Resuscitation
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