160 CARDIOPULMONARY RESUSCITATION IN MICROGRAVITY

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Abstract Introduction The increase of human space missions in microgravity conditions has led the scientific community to investigate the potential effects on astronauts' bodies. There is a high incidence of cardiovascular complications, with cardiac arrest being among the most difficult to manage. On earth, guidelines regarding cardiopulmonary resuscitation are constantly updated; however, in microgravity, the literature on the subject is still lacking. The aim of this study is to review the available literature and lay the foundation for further nursing developments in this regard. Materials and Methods A literature review was conducted by consulting Pubmed as the database. The research question was, "How is CPR performed on the astronaut suffering from cardiac arrest during space flight?" As inclusion criteria, we considered all relevant studies in the literature in the last 10 years, using MeSH terms. Results and Discussion The studies reviewed showed that there are 5 possible methods of cardiopulmonary resuscitation in the space environment (Consensus of 2015) : the Reverse Bear Hug Method; the Side-Straps Method; the Evetts-Russomano Method; the Handstand Method; and the Waist Straddle Method. Mackaill et all, through a simulation on a parabolic flight, a dummy and 10 different operators, demonstrated that the Russomano maneuver is capable of sustaining the cardiac circulation by conferring effective manual chest compressions. Hinkelbein et all, drafted a first guideline regarding resuscitation maneuvers. The results of the study also show that defibrillation and ventilation appear to be techniques that have not yet been investigated. The belief remains that BLSD and ALS protocols can be applied in the same manner as applied on Earth. Schimtz et all, with an RCT study that included 15 volunteers and a simulation dummy placed underwater (an environment similar to space characteristics), studied 2 different resuscitation techniques, comparing the Schimtz-Hinkelbein Method and the Cologne Method. The former method demonstrated a better depth and frequency of repetitions of manual compressions. Subsequently, Forti and his collaborators, highlighted the application of automatic mechanical compression devices generating effective compressions. Conclusion To date there is little evidence to state with certainty that exclusively one method of cardiopulmonary resuscitation is effective in the aerospace environment. Since the emergency of cardiac arrest is a major problem there is a need to study these processes more thoroughly and entrust health care professionals with the management, practice and theory of such space dynamics also in view of the arrival of the nursing presence during missions in space.