Ultrasound guided femoral artery access system (UFAAS) and method to enhance brain perfusion during neuroprotective CPR
A handheld ultrasound guiding system for the transcutaneous delivery of a needle into blood vessel that can be used to then deliver a guidewire, the battery powered light-weight device consisting of a phased array ultrasound generator, a transducer probe, a screen, computer processor that is mechanically coupled to a needle holder mounted at an angle to the ultrasound probe, the needle is mounted such that it can be advanced into a target blood vessel that is being visualized real-time by the ultrasound probe.
1. A method of performing cardiovascular resuscitation, comprising:
elevating an 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;
compressing the individual's chest while the individual's head, shoulders, and heart are elevated;
regulating an intrathoracic pressure of the individual while the individual's head, shoulders, and heart are elevated relative to the lower body; and
performing REBOA on the individual by positioning an intra-aortic balloon in the individual's aorta using an ultrasound-guided cannulation device and inflating the intra-aortic balloon.
2. The method of performing cardiovascular resuscitation of claim 1 , further comprising:
performing active compression decompression cardiopulmonary resuscitation on the individual while the individual is in a supine position in general alignment with the horizontal plane prior to elevating the individual's head, shoulders, and heart.
3. The method of performing cardiovascular resuscitation of claim 1 , further comprising:
actively decompressing the individual's chest between each chest compression.
4. The method of performing cardiovascular resuscitation of claim 1 , wherein:
regulating the intrathoracic pressure comprises interfacing an impedance threshold device with the individual's airway.
5. The method of performing cardiovascular resuscitation of claim 1 , wherein:
elevating the individual's head, shoulders, and heart comprises elevating the individuals' head to a height of between 10 cm and 30 cm above the horizontal plane and elevating the individual's heart to a height of between 5 cm to 15 cm above the horizontal plane.
6. The method of performing cardiovascular resuscitation of claim 1 , wherein:
REBOA is performed on the individual while the individual's head, shoulders, and heart are elevated.
7. The method of performing cardiovascular resuscitation of claim 1 , wherein:
positioning the intra-aortic balloon in the individual's aorta using the ultrasound-guided cannulation device comprises:
locating a femoral artery of the individual using a display device of the ultrasound-guided cannulation device;
inserting a needle into the femoral artery;
advancing a guidewire into the femoral artery via a hollow bore of the needle; and
advancing the intra-aortic balloon to the aorta using the guidewire.
8. The method of performing cardiovascular resuscitation of claim 1 , further comprising:
keeping the intra-aortic balloon in an inflated state for a predetermined period of time after a return of circulation to the individual.
9. The method of performing cardiovascular resuscitation of claim 8 , wherein:
the predetermined period of time is up to one hour.
10. The method of performing cardiovascular resuscitation of claim 1 , further comprising:
deflating the intra-aortic balloon after a return of circulation to the individual upon determining that a physiological measurement of the individual has reached a particular value.
11. The method of performing cardiovascular resuscitation of claim 10 , wherein:
the physiological measurement comprises a blood pressure of the individual.
12. The method of performing cardiovascular resuscitation of claim 1 , further comprising:
deflating the intra-aortic balloon after a return of circulation to the individual, wherein one or both of a timing and a rate of deflation is controlled using a closed loop feedback system with one or more physiologic measurements.
13. The method of performing cardiovascular resuscitation of claim 1 , further comprising:
deflating the intra-aortic balloon after a return of circulation to the individual, wherein one or both of a timing and a rate of deflation is controlled using an open loop feedback system with one or more physiologic measurements.
14. The method of performing cardiovascular resuscitation of claim 1 , further comprising:
deflating the intra-aortic balloon after a return of circulation to the individual, wherein deflation of the intra-aortic balloon is coordinated with a change in elevation of the individual's head, shoulders, and heart.
15. The method of performing cardiovascular resuscitation of claim 14 , wherein:
coordination of the deflation of the intra-aortic balloon is performed by monitoring blood flow to the individual's brain.
16. The method of performing cardiovascular resuscitation of claim 15 , wherein:
monitoring blood flow to the individual's brain is performed using one or both of a measurement of end tidal CO 2 and a measurement of cerebral oximetry.