Bringing back the nearly dead. The hope and the challenge

Despite widespread use of cardiopulmonary resuscitation, sudden cardiac arrest outside of a hospital setting results in death most of the time. Hoping to improve resuscitation outcomes, University of Minnesota researchers have focused their efforts on understanding cardiopulmonary physiology and improving resuscitation technologies and procedures. This article describes new technologies, designed to be used in conjunction with standard CPR, that promote recovery from cardiac arrest. Active compression-decompression CPR, which involves use of a suction cup device to draw more blood into the heart and air into the lungs, has been shown to double 1-year survival rates. The inspiratory impedance threshold valve (ITV), when attached to an endotracheal tube or face mask, has been shown to increase cardiopulmonary circulation. An electrical stimulator device for the phrenic nerve, designed to evoke a gasp reflex, is under development. This device, when used in conjunction with the ITV, is thought to increase airflow into the lungs and blood flow into the heart, and may be beneficial for patients in hemorrhagic or heat shock as well as those in cardiac arrest.