Neuroprotective CPR (Head Up CPR)

There is a growing body of literature that supports head up CPR also called neuroprotective CPR. It is far more effective at restoring circulation and improving defibrillation than previous standard CPR.  Some now call it the standard of care.  I believe that this will revolutionize CPR and resuscitation from Cardiac Arrest.

My colleagues at Hennepin Healthcare Research Institute, Keith Lurie (electrophysiologist) and Johanna Moore (Emergency Physician at Hennepin Healthcare) are the creators of Head Up CPR and have done years of brilliant research on it.  Here is a link to Keith's research on Researcgate.  Here is Johanna's Google scholar profile.

Keith is the inventor of the Inspiratory Threshold Device (ITD, ResQPod) and the ResQPump.  That combination of devices is the only method of CPR ever proven in a randomized trial to improve outcome in cardiac arrest: ResQTrial, published in Lancet in 2011: Treatment of out-of-hospital cardiac arrest with an impedance threshold device and active compression decompression cardiopulmonary resuscitation improves survival with good neurological outcome: results from the ResQTrial.  

(We also now have double sequential defibrillation). 

This research team at Hennepin (Dept of EM) is now both studying and implementing compression decompression CPR with additional head up CPR, and a new head up CPR device called the Elegard.  

See these 2 studies of head up CPR:

1) In porcine model:  Controlled sequential elevation of the head and thorax combined with active compression decompression cardiopulmonary resuscitation and an impedance threshold .  

2) Use in humans: Head and thorax elevation during cardiopulmonary resuscitation using circulatory adjuncts is associated with improved survival

Read more about the Elegard here at EMS world: Raises Head, Looks Around: The State of Elevated CPR

Here I will put articles and lectures that discuss Neuorprotective CPR.

1. 2023 Urban Fire Forum Position Statement.

First-In Responders Providing Neuroprotective (“Heads-Up”) CPR as the Standard of Care for Emergency Medical Services Systems

2.  From Medscape: Novel Resuscitation for Patients With Nonshockable Rhythms in Cardiac Arrest

3. Lecture on Neuroprotective CPR by Keith Lurie at Florida EMS Webinar