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Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity—A Manikin Study

Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, 50937 Cologne, Germany
Working Group Emergency Medicine and Air Rescue, German Society of Aviation and Space Medicine (DGLRM), 80331 Munich, Germany
Working Group Standards, Recommendations, and Guidelines, German Society of Aviation and Space Medicine (DGLRM), 80331 Munich, Germany
Space Medicine Group, European Society of Aerospace Medicine (ESAM), 50937 Cologne, Germany
Department of Sleep and Human Factors Research, Institute of Aerospace Medicine, German Aerospace Center, 51149 Cologne, Germany
Department of Anesthesia and Intensive Care, Örebro University Hospital, 701 85 Örebro, Sweden
Department of Anesthesiology, Aurora St. Luke’s Medical Center, Milwaukee, WI 53215, USA
Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK
Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences & Medicine, King’s College London, London SE1 9RT, UK
Anesthesiology and Intensive Care Department, University Hospital of Brest, 29609 Brest, France
Anesthesiology Department, South Brittany General Hospital, 56322 Lorient, France
Department of Anaesthesiology, Critical Care, Emergency Medicine and Pain Therapy, Klinikum Oldenburg, Medical Campus, University of Oldenburg, 26133 Oldenburg, Germany
Author to whom correspondence should be addressed.
Academic Editors: Timur Sellmann and Stephan Marsch
J. Clin. Med. 2022, 11(3), 646;
Received: 14 December 2021 / Revised: 24 January 2022 / Accepted: 25 January 2022 / Published: 27 January 2022
(This article belongs to the Special Issue Cardiopulmonary Resuscitation: Clinical Updates and Perspectives)
Background: Although there have been no reported cardiac arrests in space to date, the risk of severe medical events occurring during long-duration spaceflights is a major concern. These critical events can endanger both the crew as well as the mission and include cardiac arrest, which would require cardiopulmonary resuscitation (CPR). Thus far, five methods to perform CPR in microgravity have been proposed. However, each method seems insufficient to some extent and not applicable at all locations in a spacecraft. The aim of the present study is to describe and gather data for two new CPR methods in microgravity. Materials and Methods: A randomized, controlled trial (RCT) compared two new methods for CPR in a free-floating underwater setting. Paramedics performed chest compressions on a manikin (Ambu Man, Ambu, Germany) using two new methods for a free-floating position in a parallel-group design. The first method (Schmitz–Hinkelbein method) is similar to conventional CPR on earth, with the patient in a supine position lying on the operator’s knees for stabilization. The second method (Cologne method) is similar to the first, but chest compressions are conducted with one elbow while the other hand stabilizes the head. The main outcome parameters included the total number of chest compressions (n) during 1 min of CPR (compression rate), the rate of correct chest compressions (%), and no-flow time (s). The study was registered on (NCT04354883). Results: Fifteen volunteers (age 31.0 ± 8.8 years, height 180.3 ± 7.5 cm, and weight 84.1 ± 13.2 kg) participated in this study. Compared to the Cologne method, the Schmitz–Hinkelbein method showed superiority in compression rates (100.5 ± 14.4 compressions/min), correct compression depth (65 ± 23%), and overall high rates of correct thoracic release after compression (66% high, 20% moderate, and 13% low). The Cologne method showed correct depth rates (28 ± 27%) but was associated with a lower mean compression rate (73.9 ± 25.5/min) and with lower rates of correct thoracic release (20% high, 7% moderate, and 73% low). Conclusions: Both methods are feasible without any equipment and could enable immediate CPR during cardiac arrest in microgravity, even in a single-helper scenario. The Schmitz–Hinkelbein method appears superior and could allow the delivery of high-quality CPR immediately after cardiac arrest with sufficient quality. View Full-Text
Keywords: CPR; microgravity; submerged model; spaceflight; resuscitation CPR; microgravity; submerged model; spaceflight; resuscitation
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MDPI and ACS Style

Schmitz, J.; Ahlbäck, A.; DuCanto, J.; Kerkhoff, S.; Komorowski, M.; Löw, V.; Russomano, T.; Starck, C.; Thierry, S.; Warnecke, T.; Hinkelbein, J. Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity—A Manikin Study. J. Clin. Med. 2022, 11, 646.

AMA Style

Schmitz J, Ahlbäck A, DuCanto J, Kerkhoff S, Komorowski M, Löw V, Russomano T, Starck C, Thierry S, Warnecke T, Hinkelbein J. Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity—A Manikin Study. Journal of Clinical Medicine. 2022; 11(3):646.

Chicago/Turabian Style

Schmitz, Jan, Anton Ahlbäck, James DuCanto, Steffen Kerkhoff, Matthieu Komorowski, Vanessa Löw, Thais Russomano, Clement Starck, Seamus Thierry, Tobias Warnecke, and Jochen Hinkelbein. 2022. "Randomized Comparison of Two New Methods for Chest Compressions during CPR in Microgravity—A Manikin Study" Journal of Clinical Medicine 11, no. 3: 646.

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