New technology aims to close the gap in resuscitation. In an interdisciplinary cooperation project for first responders, doctors at Leipzig University Hospital are developing a measuring device that shows whether chest compressions ensure sufficient cerebral blood flow. Heart Foundation supports with 95.000 euros.
In the event of a cardiac arrest, first responders must immediately begin chest compressions to ensure the affected person's survival until rescue workers can get the stopped heart beating again. With cardiac massage, first aiders bridge the heart's suspended pumping function by using stretched arms to press the sternum deeply (5 to 6 cm) and quickly (100 to 120 times per minute) towards the spine: this is how the blood and thus oxygen are brought in pumped through the systemic circulation and to the brain, so that brain cells are protected from dying (information: https://herzstiftung.de/wiederbelebung). “Cardiac massage is crucial for the survival of the emergency patient and for avoiding serious long-term damage to the brain and other organs until the emergency services arrive,” emphasizes cardiologist Prof. Dr. med. Thomas Voigtländer, Chairman of the Board of the German Heart Foundation. Every year more than 65.000 people in Germany die from sudden cardiac death.
In the research project “BRAINSAVER” (English for “brain saver”), Leipzig researchers led by cardiologist PD Dr. med. Karsten Lenk, managing senior physician of the Clinic and Polyclinic for Cardiology (Director: Prof. Dr. Ulrich Laufs) at the Leipzig University Hospital and other scientists from the Innovation Center for Computer Assisted Surgery (ICCAS) at the University of Leipzig and the Society for Applied Medical Physics and Technology ( GAMPT) in Merseburg focuses on the quality of cardiac massage as a crucial component in their work.
The research is supported by funding from the Heart Foundation amounting to 95.000 euros as part of the “Sudden Cardiac Death” special research funding initiative. Information about the eleven projects of the special funding initiative “Sudden Cardiac Death” (volume: one million euros) can be found at https://herzstiftung.de/forschung-herztod
Dr. With the “Brainsaver” cooperation project, Lenk and colleagues have developed the prototype of an ultrasound-supported measuring device in a neck brace, with the help of which it can be seen when performing chest compressions whether the pressure is sending a sufficient amount of blood through the systemic circulation and thus into the brain of the person Emergency patients are pumped.
Like “Wearable”, Brainsaver measures the blood flow through the carotid artery
Studies have already suggested that blood flow through the carotid artery is a sign of how well chest compressions are being performed. “The aim is to use cardiac massage to continue supplying the brain with the oxygen-rich blood that is still in the body until the heart gets going again,” explains Lenk. Time is life in cardiac arrest: for every minute that passes without chest compressions, the chances of survival decrease by ten percent.
In addition, of the at least 50.000 people in Germany who require resuscitation every year, only around ten percent of patients leave the clinic with an acceptable neurological result without serious long-term damage, experts estimate (1,2). “CPR is of such vital importance that it must be carried out immediately, effectively and correctly,” emphasizes Dr. Steering.
The Brainsaver is easy to use
The Leipzig researchers have therefore developed the neck brace with an integrated Doppler sonography probe so that it can be used by rescue teams even without prior comprehensive sonography training. The neck brace consists of an immobilization collar that is used in intensive care and emergency medicine to protect the neck and neck area. Thanks to evaluation software, the device automatically records blood flow speeds and displays them on a mobile monitor that is connected to the Brainsaver. A signal tone is intended to warn the first responders during chest compressions as soon as the ultrasound probe indicates that the body's circulation is undersupplied. “The probe uses the blood flow in the carotid artery, the Arteria Carotis Communis, which supplies the brain with blood,” explains Dr. Steering. The significance of the blood flow in the carotid artery is important to the researchers in many ways:
– for determining the effectiveness of cardiac massage,
– for forecast estimation and
– it enables feedback for those performing the chest compressions.
The Brainsaver prototype that Dr. Lenk and his colleague Dr. Georg Scheck, senior physician at the Clinic and Polyclinic for Cardiology and the Central Emergency Room at Leipzig University Hospital, developed in collaboration with ICCAS and GAMPT, contains an algorithm that determines the depth of the target vessel under the skin and specifies the measuring range of the ultrasound device. “Quick and effortless placement of the ultrasound probe and reliable automatic detection of the flow spectrum are one of the most important technical requirements for clinical use of the neck brace,” explains Dr. Steering.
Dr. was of crucial importance for the development and realization of the Brainsaver prototype. According to Lenk, the interdisciplinary collaboration between the doctors of the cardiology clinic and polyclinic as well as the central emergency room at the Leipzig University Hospital, the engineers Reinhard Fuchs and Prof. Dr. Thomas Neumuth from ICCAS and the physicist Dr. Michael Schultz from GAMPT.
Initial method tests on test subjects were promising
Initial tests on subjects from the research group are promising. However, the Brainsaver must be gradually tested in the clinical area. In an initial test phase for technical feasibility, the “brain saver” has to prove itself at the Leipzig University Hospital on 100 patients without cardiac arrest and then on patients in the intensive care and monitoring wards of the university hospital: on 96 patients in shock and on 80 patients under resuscitation. “We are now examining the usefulness of the device so that perhaps all rescue units – initially in Leipzig – will be equipped with it in the future.”
Source: innovations report from December 12.12.2023, XNUMX