Abstract Presented at AHA ReSS Shows AdvancedCPR Solutions’ Method of ElevatedCPR Maximizes Cerebral Perfusion
[November 13, 2018: Minneapolis, MN] An abstract presented at the American Heart Association’s Resuscitation Science Symposium demonstrated that emerging medical device firm AdvancedCPR Solutions’ novel method of ElevatedCPR maximizes cerebral perfusion during CPR. The abstract, Controlled Progressive Elevation Maximizes Cerebral Perfusion Pressure During Head up CPR in a Swine Model of Cardiac Arrest, presented November 11 by Johanna Moore, MD, evaluated the effect of controlled elevation of the head and thorax, commonly called head up CPR (HUP), during cardiopulmonary resuscitation (CPR) in an animal model.
The two-part study examined whether there was an optimal degree of maximum elevation, as well as an optimal elevation sequence, over 5-minute intervals during device-assisted head up CPR incorporating active compression decompression CPR and an impedance threshold device (ACD+ITD CPR). A group of specimens was tested using three elevation angles (20º or 30º or 40º) in a randomized order, and subsequently a second group was tested using specific elevation sequences (20º to 30º to 40º versus 40º to 30º to 20º). The elevation sequence of 20º to 30º to 40º showed significantly higher cerebral perfusion pressure throughout the resuscitation.
After 20 minutes of CPR with the sequence of 20º to 30º to 40º, the authors observed that cerebral perfusion pressures were 80% of normal physiological value. The authors concluded, “There did not appear to be an optimal HUP angle during ACD+ITD CPR. By contrast, there was a novel optimal HUP sequence (20,30,40) that resulted in significantly higher CerPP, suggesting controlled progressive elevation is important when performing HUP CPR compared with a rapid and immediate elevation of the head and thorax.”
ElevatedCPR therapy is intended to help improve outcomes after cardiac arrest, one of the leading causes of death worldwide, by positioning the head and thorax to optimize circulation to the brain and heart during CPR. ElevatedCPR therapy, also called head up or gravity assisted CPR, is a method for performing CPR while the head, heart and shoulders of the patient are lifted in a multi-angled incline. This positioning allows the body to drain venous blood from the brain while CPR is being performed; and evidence shows a number of benefits associated with this positioning relative to intracranial pressure (ICP), cerebral perfusion pressure (CerPP) and coronary perfusion pressure (CorPP). ElevatedCPR therapy is intended to be used with a bundle of care optimally including active compression-decompression CPR devices and an impedance threshold device to help regulate the intrathoracic pressure while CPR is being performed.
Initial studies exploring ElevatedCPR therapy as part of this bundle of care have shown a strong potential to improve resuscitation and survival from sudden cardiac arrest. Pre-clinical studies have shown doubled blood flow to and through the brain and other vital organs compared to today’s best-of-class CPR techniques and devices. In addition, when compared to circulation from hands-only CPR with the patient supine or head flat, the increase in cerebral circulation is profound, nearly 4-fold after 15 minutes of CPR. ElevatedCPR therapy also produces an immediate and significant reduction in intracranial pressure.2
The company’s initial device, the EleGARD Patient Positioning System (“EleGARD,” formerly MRS 525 Patient Positioning System), delivers precise patient positioning for the execution of high quality ElevatedCPR therapy in the pre-hospital and hospital setting. The EleGARD will be commercially available in 2019.
Founded in Minneapolis, Minnesota in 2015 by an experienced team that previously developed multiple novel resuscitation technologies currently in widespread clinical practice, AdvancedCPR Solutions (formerly Minnesota Resuscitation Solutions) is an early stage medical device firm focused on the development and commercialization of ElevatedCPR therapy delivery mechanisms, methods and devices to potentially improve survival of cardiac arrest.
 Moore J, Segal N, Lick M, Dodd K, et al. Head and thorax elevation during active compression decompression cardiopulmonary resuscitation with an impedance threshold device improves cerebral perfusion in a swine model of prolonged cardiac arrest. Resuscitation. 2017;2017(121):195-200. doi: http://dx.doi.org/10.1016/j.resuscitation.2017.07.033.
 Moore J, Holley J, Segal N, Lick M. et al. Consistent head up cardiopulmonary resuscitation haemodynamics are observed across porcine and human cadaver translational models. Resuscitation. 2018; https://doi.org/10.1016/j.resuscitation.2018.04.009