Methods and systems to reduce brain damage
A method to improve neurologically-intact survival rates after cardiac arrest may include performing CPR on an individual in cardiac arrest while the individual is in a supine position in general alignment with a horizontal plane. The method may include elevating the individual's head, shoulders, and heart relative to the individual's lower body while the individual's lower body remains generally aligned with the horizontal plane to cause blood to actively drain venous blood from the brain to reduce intracranial pressure. The method may include performing chest compressions on the individual and actively decompressing the individual's chest while the individual's head, shoulders, and heart are elevated.
1. A method to improve neurologically-intact survival rates after cardiac arrest, comprising:
performing CPR on an individual in cardiac arrest while the individual is in a supine position in general alignment with a horizontal plane;
elevating the individual's head, shoulders, and heart relative to the individual's lower body while the individual's lower body remains generally aligned with the horizontal plane to cause blood to actively drain venous blood from the individual's brain to reduce intracranial pressure;
performing chest compressions on the individual and actively decompressing the individual's chest while the individual's head, shoulders, and heart are elevated; and
after a successful resuscitation and CPR is no longer needed, lowering the individual's head, shoulders, and heart over a period of between about 1 and 10 seconds upon detecting that a sufficient mean arterial pressure is no longer maintained.
2. The method to improve neurologically-intact survival rates after cardiac arrest of claim 1 , wherein:
the head is elevated to a height of between about 10 cm and 30 cm above the horizontal plane and the heart is elevated to a height of between about 2 cm and 10 cm above the horizontal plane.
3. The method to improve neurologically-intact survival rates after cardiac arrest of claim 1 , further comprising:
regulating an intrathoracic pressure of the individual while the individual's head, shoulders, and heart are elevated relative to the lower body.
4. The method to improve neurologically-intact survival rates after cardiac arrest of claim 1 , wherein:
elevating the individual's head, shoulders, and heart relative to the individual's lower body comprises elevating the individual's head, shoulders, and heart to an intermediate elevation position; and
the method further comprises:
elevating the individual's head, shoulders, and heart a second time to a final elevation position; and
performing chest compressions on the individual and actively decompressing the individual's chest while the individual's head, shoulders, and heart are at the final elevation position.
5. The method to improve neurologically-intact survival rates after cardiac arrest of claim 4 , wherein:
the individual's head, shoulders, and heart are elevated to the intermediate elevation position at a rate that is slower than a rate at which the individual's head, shoulders, and heart are elevated to the final elevation position.
6. The method to improve neurologically-intact survival rates after cardiac arrest of claim 1 , wherein:
when elevated, a vertical distance between the individual's head and heart is between about 5 cm and 20 cm.
7. A method to improve neurologically-intact survival rates after cardiac arrest, comprising:
performing active compression decompression cardiopulmonary resuscitation (ACD-CPR) on an individual in cardiac arrest while the individual's heart is at a position of between about 0 cm to 8 cm above horizontal and the individual's head is at a position of between about 0 and 15 cm above horizontal;
elevating the individual's head, shoulders, and heart relative to the individual's lower body while the individual's lower body remains generally aligned with a horizontal plane to cause blood to actively drain venous blood from the individual's brain to reduce intracranial pressure, wherein the head is elevated to a height of between about 10 cm and 30 cm above the horizontal plane and the heart is elevated to a height of between about 2 cm and 10 cm above the horizontal plane;
performing chest compressions on the individual and actively decompressing the individual's chest while the individual's head, shoulders, and heart are elevated; and
lowering the individual's head, shoulders, and heart over a period of between about 1 and 10 seconds upon detection of a stable heart rhythm.
8. The method to improve neurologically-intact survival rates after cardiac arrest of claim 7 , wherein:
regulating an intrathoracic pressure of the individual using an intrathoracic pressure regulation device while the individual's head, shoulders, and heart are elevated relative to the lower body.
9. The method to improve neurologically-intact survival rates after cardiac arrest of claim 7 , wherein:
upon stopping the performance of CPR, maintaining the individual in a head up position with the individual's head, shoulders, and heart elevated as long as a sufficient mean arterial pressure is maintained to support blood flow to the brain in the head up position.
10. The method to improve neurologically-intact survival rates after cardiac arrest of claim 9 , wherein:
the sufficient mean arterial pressure is between about 60 mm Hg and 70 mm Hg.
11. The method to improve neurologically-intact survival rates after cardiac arrest of claim 7 , further comprising:
detecting a stable heart rhythm; and
halting the performance of chest compressions based on the detection of the stable heart rhythm.
12. The method to improve neurologically-intact survival rates after cardiac arrest of claim 11 , wherein:
the stable heart rhythm is detected using an electrocardiogram.
13. A method to improve neurologically-intact survival rates after cardiac arrest, comprising:
performing cardiopulmonary resuscitation (CPR) on an individual in cardiac arrest while the individual's heart is at a position of between about 0 cm to 8 cm above horizontal and the individual's head is at a position of between about 0 and 15 cm above horizontal;
elevating the individual's head, shoulders, and heart relative to the individual's lower body while the individual's lower body remains generally aligned with a horizontal plane to cause blood to actively drain venous blood from the individual's brain to reduce intracranial pressure, wherein the head is elevated to a height of between about 10 cm and 30 cm above the horizontal plane and the heart is elevated to a height of between about 2 cm and 10 cm above the horizontal plane;
delivering chest compressions to the individual's chest using a CPR assist device while the individual's head, shoulders, and heart are elevated;
upon stopping the performance of CPR, maintaining the individual in a head up position with the individual's head, shoulders, and heart elevated as long as a sufficient mean arterial pressure is maintained to support blood flow to the brain in the head up position; and
lowering the individual's head, shoulders, and heart over a period of between about 1 and 10 seconds upon detecting that the sufficient mean arterial pressure is no longer maintained.
14. The method to improve neurologically-intact survival rates after cardiac arrest of claim 13 , further comprising:
regulating an intrathoracic pressure of the individual using an intrathoracic pressure regulation device while the individual's head, shoulders, and heart are elevated relative to the lower body.
15. The method to improve neurologically-intact survival rates after cardiac arrest of claim 13 , wherein:
the individual's head, shoulders, and heart are elevated within 10 minutes of onset of cardiac arrest.
16. The method to improve neurologically-intact survival rates after cardiac arrest of claim 13 , further comprising:
therapeutically cooling the individual during the delivery of chest compressions.
17. The method to improve neurologically-intact survival rates after cardiac arrest of claim 13 , further comprising:
therapeutically cooling the individual after halting the delivery of chest compressions.
18. An after-cardiac arrest brain trauma reduction system, comprising:
a base;
a support surface that is movably coupled with the base;
a cardiopulmonary resuscitation (CPR) assist device that is positionable in alignment with the heart and thorax of the individual;
one or more processors; and
a memory having instructions stored thereon that, when executed, cause the one or more processors to:
send instructions to raise the support surface to elevate the head, shoulders, and heart of an individual such that the heart is elevated between about 2 and 10 cm above the horizontal plane and the head is elevated between about 5 and 30 cm above the horizontal plane;
cause the CPR assist device to repeatedly compress the individual's chest while the support surface is raised; and
send instructions to halt chest compressions and lower the individual's head, shoulders, and heart over a period of between about 1 and 10 seconds upon detecting that a sufficient mean arterial pressure is no longer maintained.