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Design Innovation

Miniaturization of a Chest Compressor for Cardiopulmonary Resuscitation

[+] Author and Article Information
Carlos Castillo, Joe Bisera, Giuseppe Ristagno

 Weil Institute of Critical Care Medicine, 35100 Bob Hope Drive, Rancho Mirage, CA 92270

Wanchun Tang

 Weil Institute of Critical Care Medicine, 35100 Bob Hope Drive, Rancho Mirage, CA 92770; Keck School of Medicine, University of Southern California, Los Angeles, CA 90033

Max Harry Weil1

 Weil Institute of Critical Care Medicine, 35100 Bob Hope Drive, Rancho Mirage, CA 92770; Keck School of Medicine, University of Southern California, Los Angeles, CA 90033weilm@weiliccm.org

1

Corresponding author.

J. Med. Devices 3(1), 015001 (Dec 18, 2008) (5 pages) doi:10.1115/1.3040075 History: Received November 27, 2007; Revised October 30, 2008; Published December 18, 2008

A miniaturized chest compressor (MCC®) for cardiopulmonary resuscitation (CPR) was designed to serve as a compact portable device to overcome limitations of manual chest compression and of currently marketed mechanical devices. We sought to especially address constraints of size and weight of current devices, together with the need for ease of application and consistent compressions with appropriate force and depth. We further intended that the device allows for ease of evacuation and transport through small spaces. These objectives are responsive to the increasingly recognized requirements for uninterrupted chest compression including that which results from operator fatigue during manual compressions. Utilizing a garment applied to the torso, the device incorporated a telescopic piston for chest compression. The compressor was pneumatically powered so as to avoid the added weight and potential electrical adversity of power delivered by batteries. Pneumatic power was supplied by the same compressed air or oxygen tank, which is routinely carried by professional emergency medical rescuers. The MCC® was tested on a porcine model during cardiac arrest and resuscitation with comparisons to the current industry standard, the Michigan Thumper®. Arterial, carotid, and coronary perfusion pressures, together with end-tidal carbon dioxide as a surrogate for cardiac output, were measured. The MCC® threshold levels of pressure, flow, and end-tidal PCO2 are achieved, which were predictive of successful defibrillation with restoration of spontaneous circulation. We conclude that the MCC® is as effective as that of the established industry standard, the Michigan Thumper®, with the potential advantage of portability and facile application, especially for out-of-hospital resuscitation.

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Figures

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Figure 1

(a) Comparison of devices, namely, the Michigan Thumper® and the MCC® and (b) the application to the chest of an adult CPR training manikin

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Figure 2

A close-up of the MCC®

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Figure 3

The three modules of the MCC®

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Figure 4

Circuit design and timing sequence of the compressor module. (a) Pneumatic circuit provides for pilot pressure one (P1), pilot pressure two (P2), exhaust one (EX1), exhaust two (EX2), output one (OUT1), output two (OUT2), flow control one (R1), and flow control two (R2). (b) Timing sequence, including main input pressure (input), pilot pressure one (P1), pilot pressure (P2), and pneumatic module output (output).

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Figure 5

Pressure measured inside of the telescopic piston and acceleration measured on the precordium (chest) with the Stat∙Padz II adult pads (Zoll Medical Corporation, Chelmsford, MA)

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Figure 6

Intrathoracic pressures measured during recoil phase of compression. Baseline (BL), prior to onset of ventricular fibrillation, and during chest compression following inducing VF.

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Figure 7

Effects of the MCC® on (a) coronary perfusion pressure, expired carbon dioxide tension, and carotid flow. (b) Applied force to the chest (piston force) and chest displacement (displacement). During compression over a 5 min interval.

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