AP090 Cerebral flow improvement during CPR with LUCAS measured by Doppler

Abstract

Great quality chest compressions are the most important maneouvers together with prompt defibrillation to guarantee critical flow to heart and brain in a sudden cardiac arrest treatment. Cerebral flow can be measured by trans-cranial doppler; normal rates for a healthy person are 60–80 cm/s. LUCAS® devices performs 5 cm depth chest compressions at a rate of 100 per minute, becoming immune to tiredness. Aim: To compare the middle cerebral artery flow measured by doppler, with or without LUCAS® chest compressor during cardio-pulmonary resuscitation. Methods: Prospective study from January 2011 to June 2011, where one prehospital advanced life support unit (ALSU) from the city of Barcelona was provided with the Toshiba Viamo portable ultrasound scanner and one physician was trained in cerebrovascular ultrasound during 1 month previously to the beggining of the study. Cerebral middle artery flow at 5–6 cm was mesured in all the sudden cardiac arrest (SCA) assisted by this trained unit in the study period, previously and after the LUCAS® device was placed. Results: 6 patients with SCA were assisted, 3 of them males (66±10.53 years old) and 3 females (48.33±22.67 years old). 1 patient with a SCA caused by a STEMI recovered spontaneous circulation (ROSC) before the ultrasound scan could be performed and his flow after ROSC was 96 cm/s. 2 young females suffered SCA as a consequence of a spontaneous subarachnoid haemorrhage (SSH) and no flow was observed with manual chest compressions nor with LUCAS®, but one of them ROSC. In the other 3 patients the median flow was 31.6±8.32 cm/s in the manual group in front of 50.6±27.12 cm/s in LUCAS® group. Conclusions: Patients with SCA due to SSH seem not to receive cerebral flow during resuscitation with manual chest compressions nor with LUCAS®. LUCAS seems to improve cerebral flow compared with manual CPR during the resuscitation of patients with a non-SSH SCA.