The system of Controlled Automated Reperfusion of the whoLe Body - Delighting News regarding Survival and Neurologic Recovery in the field of Cardiopulmonary Resuscitation

Objective:

Cardiopulmonary resuscitation (CPR) is associated with a high mortality rate and frequent neurologic damage. A severe ischemia-reperfusion (IR) injury of the whole body and the brain is the underlying cause. There is a relevant medical need to establish a medical-protocol counteracting IR of the whole body and the brain.

Method:

N=200 preclinical experiments with pigs have been performed. Animals were exposed to global warm ischemia (15 and 20 min) with subsequent CPR performed with extracorporeal circulation. Pigs were allowed to regain consciousness thereafter. Based on the results, a medical protocol was defined (Controlled Automated Reperfusion of the whoLe body-CARL). Complementary to CARL, a medical device (Controlled Integrated Resuscitation Device-CIRD; ResuSciTec GmbH, Freiburg/Germany) has been engineered. First successful application in man followed in 2015.

Results:

In designated groups of the preclinical setting (20 min ischemia), up to 90 % survival with complete clinical neurologic recovery in 90% of these animals has been observed. The application of CARL and CIRD in n=10 patients undergoing extremely prolonged CPR (CPR duration: 51-120 min) was associated with full consciousness und neurologic recovery in 5/10 of these patients.

Conclusion

There is a relevant medical-need to improve survival and neurologic recovery in patients undergoing CPR. Based on extensive research, a medical protocol CARL has been defined. The application of CARL, requires the medical device CIRD, which will be market available in 2017.

The extensive preclinical and the first clinical results are indicating, that CARL and CIRD may be the key to change the poor outcome of patients undergoing CPR.