How CCSV can Advance CPR Research
How can we improve the chances of survival of a person in cardiovascular arrest? What role does ventilation play? Initial data show that the ventilation mode CCSV (Chest Compression Synchronized Ventilation) could be useful. Here, a mechanical breath is given in sync with each chest compression.
CPR even by someone with limited medical knowledge improves the rate of survival
Chris is 45 years old, was always physically active and plays tennis three times a week. Good performance is vital to him. He ranks among the top players in his team and always tries to improve his technique. Today he’s practicing his kick serve, but something is different than usual. His heartbeat is faster than normal and suddenly his field of vision is impaired. And then it happens: While he’s tossing up the ball and swinging his racket, he suddenly collapses. Tim, the person on the other side of the net, reacts fast and rushes over to him. When Chris doesn’t respond to being shaken by the shoulders and isn’t making any breathing noises, Tim starts CPR straightaway.
“With a cardiac arrest, every second counts. If first-aiders start CPR immediately, the chances of survival are two to three times higher with a heart attack. The longer the brain is deprived of blood, the more likely the person affected will suffer lasting harm,” explains Dr. Birgit Plöger. She has been an emergency physician for over 20 years and is an expert in the field of CPR.
Ventilation during CPR with CCSV
Tim therefore did everything right and may have also saved his teammate’s life. When the emergency physician arrives shortly afterward, she takes over. Here she uses the MEDUAMT Standard² ventilator because it incorporates the CCSV ventilation mode. “It is a form of ventilation developed specifically for CPR and is easy to use. CCSV does what it’s meant to, it doesn’t interfere with the CPR. It not only provides patients with ventilation, but also has a positive influence on cardiovascular function,” explains Dr. Plöger. She’s been a user from the very start and first came into contact with the ventilation mode in 2017. When she and her then superior decided to integrate CCSV, she did not start with high expectations: “It was a new procedure that sounded good. The animal studies were compelling and the most important thing was that we knew that we wouldn’t be harming patients. On the contrary – it gave us the opportunity to improve care with a cardiac arrest.”
Simple and safe to use
Chris was lucky. Thanks to immediate CPR from his teammate and the subsequent care by the emergency medical services, his cardiac rhythm returned. To ensure that emergency physicians can use CCSV during resuscitation, EMS provider DRK-Rettungsdienst Central Hesse (RDMH) equipped all its emergency physician vehicles with MEDUMAT Standard². One important factor for Dr. Plöger: “I feel safe with CCSV. It makes CPR easier for me,” she explains.
CPR research must continue
In the University Hospital of Giessen and Marburg (UKGM), the physicians have, however, been using the ventilation mode only in the shock room so far. In the future, Dr. Plöger would like to see CCSV also being used in other areas of the hospital. “It’s easy to use, we just need to convince people more.” It’s also important that experts explain what role ventilation plays in CPR. “This issue needs to come to the fore. We know it’s important to restore the cardiovascular function. That’s something people have become increasingly aware of over the past few years. We now need to explain: What role does the form of ventilation play? Is there anything else we can optimize? Unfortunately, there haven’t been enough studies done in this field so far.” She encourages her colleagues to use CCSV: “The ventilation mode has revolutionized the way we influence breathing and cardiovascular function. The ability to improve blood flow with ventilation was something people weren’t aware of in this way before. But the breakthrough will only come with enough data so we can provide all patients with better treatment. That’s why it’d be great to find even more users so we can advance CPR research even more.”
Dr. Birgit Plöger
Dr. Birgit Plöger is a senior consultant in the Center for Emergency Medicine of the University Hospital of Gießen and Marburg. She has been an emergency physician and medical director for over 20 years as well as director of the Simulation Center in the DRK-Rettungsdient Central Hesse emergency medical services. Emergency medicine is more than just a job for Dr. Plöger. Whether it’s training colleagues or working with and on patients – she is passionate about everything she does. A passion that also comes across in our conversation.
