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Computer-Based CPR Simulation Towards Validation of AHA/ERC Guidelines

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Abstract

As per the AHA 2015 and ERC 2015 guidelines for resuscitation, chest compression depth should be between 5 and 6 cm with a rate of 100–120 compressions per minute. Theoretical validation of these guidelines is still elusive. We developed a computer model of the cardiopulmonary resuscitation (CPR) system to validate these guidelines. A lumped element computer model of the cardiovascular system was developed to simulate cardiac arrest and CPR. Cardiac output was compared for a range of compression pressures and frequencies. It was observed from our investigation that there is an optimum compression pressure and rate. The maximum cardiac output occurred at 100 mmHg, which is approximately 5.7 cm, and in the range of 100 to 120 compressions per minute with an optimum value at 110 compressions per minute, validating the guidelines. Increasing the pressure or the depth of compression beyond the optimum, limits the blood flow by depleting the volume in the cardiac chambers and not allowing for an effective stroke volume. Similarly increasing the compression rate beyond the optimum degrades the ability of the chambers to pump blood. The results also bring out the importance of complete recoil of the chest after each compression with more than 400% increase in cardiac output from 90% recoil to 100% recoil. Our simulation predicts that the recommendation to compress harder and faster is not the best counsel as there is an optimum compression pressure and rate for high-quality CPR.

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Conflict of interest

Alka Rachel John declares that she has no conflict of interest. M. Manivanan declares that he has no conflict of interest. T.V. Ramakrishnan declares that he has no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Authors and Affiliations

  1. Touch Lab, Biomedical Research Group, Department of Applied Mechanics, IIT Madras, Chennai, India

    Alka Rachel John & M. Manivannan

  2. SRMC & RI, Porur, Chennai, Tamil Nadu, India

    T. V. Ramakrishnan

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  1. Alka Rachel John
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  2. M. Manivannan
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  3. T. V. Ramakrishnan
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Correspondence to M. Manivannan.

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Associate Editors Andre Churchwell and Ajit P. Yoganathan oversaw the review of this article.

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John, A.R., Manivannan, M. & Ramakrishnan, T.V. Computer-Based CPR Simulation Towards Validation of AHA/ERC Guidelines. Cardiovasc Eng Tech 8, 229–235 (2017). https://doi.org/10.1007/s13239-017-0297-y

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