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Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity—A Manikin Study

Background: Although there have been no reported cardiac arrests in space to date, the risk of severe medical events occurring during long-duration spaceflights is a major concern. These critical events can endanger both the crew as well as the mission and include cardiac arrest, which would require...

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Autores principales: Schmitz, Jan, Ahlbäck, Anton, DuCanto, James, Kerkhoff, Steffen, Komorowski, Matthieu, Löw, Vanessa, Russomano, Thais, Starck, Clement, Thierry, Seamus, Warnecke, Tobias, Hinkelbein, Jochen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836939/
https://www.ncbi.nlm.nih.gov/pubmed/35160097
http://dx.doi.org/10.3390/jcm11030646
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author Schmitz, Jan
Ahlbäck, Anton
DuCanto, James
Kerkhoff, Steffen
Komorowski, Matthieu
Löw, Vanessa
Russomano, Thais
Starck, Clement
Thierry, Seamus
Warnecke, Tobias
Hinkelbein, Jochen
author_facet Schmitz, Jan
Ahlbäck, Anton
DuCanto, James
Kerkhoff, Steffen
Komorowski, Matthieu
Löw, Vanessa
Russomano, Thais
Starck, Clement
Thierry, Seamus
Warnecke, Tobias
Hinkelbein, Jochen
author_sort Schmitz, Jan
collection PubMed
description Background: Although there have been no reported cardiac arrests in space to date, the risk of severe medical events occurring during long-duration spaceflights is a major concern. These critical events can endanger both the crew as well as the mission and include cardiac arrest, which would require cardiopulmonary resuscitation (CPR). Thus far, five methods to perform CPR in microgravity have been proposed. However, each method seems insufficient to some extent and not applicable at all locations in a spacecraft. The aim of the present study is to describe and gather data for two new CPR methods in microgravity. Materials and Methods: A randomized, controlled trial (RCT) compared two new methods for CPR in a free-floating underwater setting. Paramedics performed chest compressions on a manikin (Ambu Man, Ambu, Germany) using two new methods for a free-floating position in a parallel-group design. The first method (Schmitz–Hinkelbein method) is similar to conventional CPR on earth, with the patient in a supine position lying on the operator’s knees for stabilization. The second method (Cologne method) is similar to the first, but chest compressions are conducted with one elbow while the other hand stabilizes the head. The main outcome parameters included the total number of chest compressions (n) during 1 min of CPR (compression rate), the rate of correct chest compressions (%), and no-flow time (s). The study was registered on clinicaltrials.gov (NCT04354883). Results: Fifteen volunteers (age 31.0 ± 8.8 years, height 180.3 ± 7.5 cm, and weight 84.1 ± 13.2 kg) participated in this study. Compared to the Cologne method, the Schmitz–Hinkelbein method showed superiority in compression rates (100.5 ± 14.4 compressions/min), correct compression depth (65 ± 23%), and overall high rates of correct thoracic release after compression (66% high, 20% moderate, and 13% low). The Cologne method showed correct depth rates (28 ± 27%) but was associated with a lower mean compression rate (73.9 ± 25.5/min) and with lower rates of correct thoracic release (20% high, 7% moderate, and 73% low). Conclusions: Both methods are feasible without any equipment and could enable immediate CPR during cardiac arrest in microgravity, even in a single-helper scenario. The Schmitz–Hinkelbein method appears superior and could allow the delivery of high-quality CPR immediately after cardiac arrest with sufficient quality.
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spelling pubmed-88369392022-02-12 Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity—A Manikin Study Schmitz, Jan Ahlbäck, Anton DuCanto, James Kerkhoff, Steffen Komorowski, Matthieu Löw, Vanessa Russomano, Thais Starck, Clement Thierry, Seamus Warnecke, Tobias Hinkelbein, Jochen J Clin Med Article Background: Although there have been no reported cardiac arrests in space to date, the risk of severe medical events occurring during long-duration spaceflights is a major concern. These critical events can endanger both the crew as well as the mission and include cardiac arrest, which would require cardiopulmonary resuscitation (CPR). Thus far, five methods to perform CPR in microgravity have been proposed. However, each method seems insufficient to some extent and not applicable at all locations in a spacecraft. The aim of the present study is to describe and gather data for two new CPR methods in microgravity. Materials and Methods: A randomized, controlled trial (RCT) compared two new methods for CPR in a free-floating underwater setting. Paramedics performed chest compressions on a manikin (Ambu Man, Ambu, Germany) using two new methods for a free-floating position in a parallel-group design. The first method (Schmitz–Hinkelbein method) is similar to conventional CPR on earth, with the patient in a supine position lying on the operator’s knees for stabilization. The second method (Cologne method) is similar to the first, but chest compressions are conducted with one elbow while the other hand stabilizes the head. The main outcome parameters included the total number of chest compressions (n) during 1 min of CPR (compression rate), the rate of correct chest compressions (%), and no-flow time (s). The study was registered on clinicaltrials.gov (NCT04354883). Results: Fifteen volunteers (age 31.0 ± 8.8 years, height 180.3 ± 7.5 cm, and weight 84.1 ± 13.2 kg) participated in this study. Compared to the Cologne method, the Schmitz–Hinkelbein method showed superiority in compression rates (100.5 ± 14.4 compressions/min), correct compression depth (65 ± 23%), and overall high rates of correct thoracic release after compression (66% high, 20% moderate, and 13% low). The Cologne method showed correct depth rates (28 ± 27%) but was associated with a lower mean compression rate (73.9 ± 25.5/min) and with lower rates of correct thoracic release (20% high, 7% moderate, and 73% low). Conclusions: Both methods are feasible without any equipment and could enable immediate CPR during cardiac arrest in microgravity, even in a single-helper scenario. The Schmitz–Hinkelbein method appears superior and could allow the delivery of high-quality CPR immediately after cardiac arrest with sufficient quality. MDPI 2022-01-27 /pmc/articles/PMC8836939/ /pubmed/35160097 http://dx.doi.org/10.3390/jcm11030646 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schmitz, Jan
Ahlbäck, Anton
DuCanto, James
Kerkhoff, Steffen
Komorowski, Matthieu
Löw, Vanessa
Russomano, Thais
Starck, Clement
Thierry, Seamus
Warnecke, Tobias
Hinkelbein, Jochen
Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity—A Manikin Study
title Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity—A Manikin Study
title_full Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity—A Manikin Study
title_fullStr Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity—A Manikin Study
title_full_unstemmed Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity—A Manikin Study
title_short Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity—A Manikin Study
title_sort randomized comparison of two new methods for chest compressions during cpr in microgravity—a manikin study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836939/
https://www.ncbi.nlm.nih.gov/pubmed/35160097
http://dx.doi.org/10.3390/jcm11030646
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