2024-10-27 00:52:00
According to the Spanish Society of Cardiology (SEC), cardiorespiratory arrest consists of the cessation of cardiac mechanical activity and is diagnosed due to the loss of consciousness, pulse and breathing. The measures applied to reverse the phenomenon are called cardiopulmonary resuscitation (CPR) and aim to prevent death due to irreversible damage to vital organs, especially the brain.
Standard CPR is usually effective in the first 10-20 minutes after cardiac arrest, but after this period the chances of success decrease rapidly and the serious neurological risk is high, as the brain begins to suffer damage due to lack of oxygen after 4 -6 minutes. minutes without adequate circulation.
In this context, some Spanish hospitals already have CARL, an innovative extracorporeal cardiopulmonary resuscitation system from the health technology company Palex, which significantly extends this standard time. Most of the stops that arrive at CARL last from 30 to 90 minutes, there are even cases of survival in stops longer than 120 minutes. This offers a last chance for recovery at both the cardiac and cerebral level to patients who have failed to recover their pulse within the time required by clinical guidelines and who until now had minimal expectations of survival.
CARL was developed by experts in cardiac surgery and medical technology, with a new therapeutic approach towards controlled, targeted and personalized whole-body reperfusion after cardiac arrest.
Improved reperfusion technology
CARL is a rather revolutionary high-end medical device that can significantly improve the quality of life of patients who survive cardiac arrest. Steffen Pooth, from the Department of Emergency Medicine at the University Hospital of Freiburg (Germany) and co-developer of the device, explains: “Based on cardiovascular research and practice, we have implemented the necessary technology so that reperfusion wherever it is controllable by emergency teams. CARL is made up of three key parts that make a big difference in the management of these patients.” First, a controller performs venous and arterial blood gas analysis, which helps monitor metabolism during reperfusion. It also measures blood pressure in the aorta, “which allows for more precise pressure management and generates pulsatile flow to improve perfusion, especially in situations where there may be non-backflow issues,” explains Dr. Pooth.
Secondly, a gas mixer allows you to avoid hyperoxygenation in the early stages of treatment, since the common practice of suddenly connecting the patient to 100% oxygen can be very harmful.
And finally, a mobile cooling unit that, without the need for an external power source, can cool a patient to a specific temperature and prevent fever during reperfusion.
“Studies have shown that with the use of eCPR a survival rate of approximately 30% is achieved in selected patients with prolonged cardiac arrest. However, with CARL, which can be considered a more specific form of eCPR, Regensburg University Hospital reported a survival rate of 50% and in a multicenter study conducted in several European countries it exceeded 40%. This is very promising, because the improvement in the survival rate in these studies has also been linked to less neurological damage, which is fundamental for the quality of life of patients”, clarifies the expert. LAURA CLAVIJO
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