Title of article :
A Dynamic Model of Rescuer Parameters for Optimizing Blood Gas Delivery during Cardiopulmonary Resuscitation
Author/Authors :
Jalali, Ali Johns Hopkins All Children’s Hospital - St. Petersburg, USA , Simpao, Allan F Department of Anesthesiology & Critical Care Medicine - Children’s Hospital of Philadelphia - Perelman School of Medicine at the University of Pennsylvania - Civic Center Blvd - Philadelphia, USA , Galvez, Jorge A Department of Anesthesiology & Critical Care Medicine - Children’s Hospital of Philadelphia - Perelman School of Medicine at the University of Pennsylvania - Civic Center Blvd - Philadelphia, USA , Berg, Robert A Department of Anesthesiology & Critical Care Medicine - Children’s Hospital of Philadelphia - Perelman School of Medicine at the University of Pennsylvania - Civic Center Blvd - Philadelphia, USA , Nadkarni, Vinay M Department of Anesthesiology & Critical Care Medicine - Children’s Hospital of Philadelphia - Perelman School of Medicine at the University of Pennsylvania - Civic Center Blvd - Philadelphia, USA , Nataraj, Chandrasekhar Department of Mechanical Engineering - Villanova University - Villanova, USA
Abstract :
#e quality of cardiopulmonary resuscitation (CPR) has been shown to impact patient outcomes. However, post-CPR
morbidity and mortality remain high, and CPR optimization is an area of active research. One approach to optimizing CPR involves
establishing reliable CPR performance measures and then modifying CPR parameters, such as compressions and ventilator breaths,
to enhance these measures. We aimed to define a reliable CPR performance measure, optimize the CPR performance based on the
defined measure and design a dynamically optimized scheme that varies CPR parameters to optimize CPR performance. Materials
and Methods. We selected total blood gas delivery (systemic oxygen delivery and carbon dioxide delivery to the lungs) as an objective
function for maximization. CPR parameters were divided into three categories: rescuer dependent, patient dependent, and constant
parameters. Two optimization schemes were developed using simulated annealing method: a global optimization scheme and a
sequential optimization scheme. Results and Discussion. Variations of CPR parameters over CPR sequences (cycles) were analyzed.
Across all patient groups, the sequential optimization scheme resulted in significant enhancement in the effectiveness of the CPR
procedure when compared to the global optimization scheme. Conclusions. Our study illustrates the potential benefit of considering
dynamic changes in rescuer-dependent parameters during CPR in order to improve performance. #e advantage of the sequential
optimization technique stemmed from its dynamically adapting effect. Our CPR optimization findings suggest that as CPR
progresses, the compression to ventilation ratio should decrease, and the sequential optimization technique can potentially improve
CPR performance. Validation in vivo is needed before implementing these changes in actual practice.
Keywords :
Dynamic , Blood , CPR , Cardiopulmonary
Journal title :
Computational and Mathematical Methods in Medicine