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Heads Up! There is No Association with Improved Outcomes for Head Up CPR: Why We Must Read Past the Abstract

Head Up (HUP) CPR may be the next critical improvement. Instead of lying the patient flat while administering compressions, HUP CPR requires the head and thorax to be elevated. The physiologic theory is that HUP allows venous blood to drain from the brain to the heart resulting in decreased intracranial pressure (ICP) and improved cerebral perfusion pressure (CPP). Increased CPP, in turn, may lead to improved neurologic outcomes. In order for HUP to be effectively delivered, it is paired with mechanical CPR (mCPR) as well as an impedance threshold device (ITD) which provides active compression-decompression.There is substantial animal data demonstrating improvements in ICP and CPP as well…

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Articles of Interest

A Revamping of an Old Practice: Head-Up CPR

In an almost comedic way, despite this evolution, “good old-fashioned” chest compressions are the only consistent intervention to improve cardiac arrest outcomes. Cardiopulmonary resuscitation (CPR), however, is not immune to this omnipresent evolution. We are reviewing a whole new way of performing this life-saving practice: head-up CPR.

From a toilet plunger to head-up CPR: Bundling systemic and regional venous return augmentation to improve the hemodynamic efficacy of chest compression

Prompt generation of blood flow at levels able to reverse – or at least ameliorate – myocardial and cerebral ischemia is critical for successful resuscitation from cardiac arrest. Yet, conventional cardiopulmonary resuscitation (CPR) fails to promote more than a small fraction of the normal cardiac output and to optimally distribute such blood flow to the coronary and cerebral circuits.

Head Up CPR & Neuroprotective Resuscitation: What’s It All About?

How do we improve the dismal 10% survival rate of out-of-hospital cardiac arrest? Who better to ask than 4-time SCA survivor and retired fire chief Wayne Kewitsch alongside emergency physician and Resuscitation Scientist Johanna Moore?

Head Up CPR - Effects Of The Cerebral And Systemic Hemodynamics?

In Seoul, South Korea, the researcher Keith Lurie dedicated his career on the hemodynamics of CPR. In particular, he began to dedicate work on the right position of the body during CPR.

Head-Up CPR

You may have heard of Head-Up CPR as a new approach to patient positioning during CPR. It may not be totally prime-time yet(although it is being used right now), but it is, thinking outside the box and concentrating on the most important part of what cardiac resuscitation is about…. saving the brain.

Head-up CPR increases odds of patient surviving neurologically

The head and shoulder elevation technique works especially well the if treatment begins less than 18 minutes after the 911 call is received, according to the paper.

Head-Up CPR May Improve Neurologically Intact Survival Rates

Head-up CPR, when applied correctly and as part of a OHCA bundle of care, has the potential to improve neurologically intact survival rates after cardiac arrest.

Heads-Up CPR: Can It Improve Outcomes?

When you compress the chest in conventional CPR, it sends an aortic pressure wave to the brain that provides blood pressure and, theoretically, blood flow. But you’re also creating a backward-moving pressure wave on the venous side. This works against venous return and increases ICP.

In the Pipeline: Head Up CPR in OHCA?

Head up (HUP) CPR is an emerging concept. The theory behind HUP is it allows for venous blood to drain from the brain to the heart thereby decreasing intracranial pressure and lowering the arterial/venous pressure waves which concuss the brain with each compression.

Why heads-up CPR is NOT ready for prehospital cardiac arrest

It’s time that EMS providers, leaders and agencies stop falling victim to models and devices touting the ability to save cardiac arrest patients. We will get much further by acting with caution, even skepticism, and asking for real proof from well-designed research studies.