# US 10,478,374 B2 · Systems and methods to increase survival with favorable neurological function after cardiac arrest > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,478,374 B2 - Document ID: US10478374B2 - Status: Granted - Kind: B2 - Application number: 15/158,738 - Filed: 2016-05-19 - Published: 2016-09-15 - Granted: 2019-11-19 - Earliest claimed: 2007-04-19 - Assignees: ZOLL Medical Corporation - Applicants: Advanced Circulatory Systems, Inc. - Inventors: Keith G. Lurie; Anja Metzger - Web page: https://patentgrep.com/patent/US10478374B2 ## CPC - A61H 31/007: {Manual driven} - A61H 31/004: {Heart stimulation} - A61H 31/005: {with feedback for the user} - A61M 16/0048: {Mouth-to-mouth respiration (teaching or training models G09B23/288)} - A61M 16/0084: {self-reinflatable by elasticity, e.g. resuscitation squeeze bags} - A61M 16/10: Preparation of respiratory gases or vapours - A61M 16/208: {Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves} - A61H 31/006: {Power driven} - A61H 31/02: Iron lungs - A61H 2031/002: {fixed on the chest by adhesives} - A61H 2201/0173: Means for preventing injuries - A61H 2201/018: By limiting the applied torque or force - A61H 2201/0184: by raising an alarm - A61H 2201/107: Respiratory gas - A61H 2201/5061: Force sensors - A61H 2201/5071: Pressure sensors - A61H 2201/5084: Acceleration sensors - A61H 2205/084: Chest - A61H 2230/04: Heartbeat characteristics, e.g. E.G.C., blood pressure modulation - A61H 2230/065: used as a control parameter for the apparatus - A61H 2230/40: Respiratory characteristics - A61H 2230/65: Impedance, e.g. skin conductivity; capacitance, e.g. galvanic skin response [GSR] - A61M 2202/0208: Oxygen - A61M 2205/583: by visual feedback - A61H: PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY (electrotherapy, magnetotherapy, radiation therapy or ultrasound therapy A61N) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract A system includes a guidance device that provides feedback to a user to compress a patient's chest at a rate of between about 90 and 110 compressions per minute and at a depth of between about 4.5 centimeters to about 6 centimeters. The system includes a pressure regulation system having a pressure-responsive valve that is configured to be coupled to a patient's airway. The pressure-responsive valve is configured to remain closed during successive chest compressions in order to permit removal at least about 200 ml from the lungs in order to lower intracranial pressure to improve survival with favorable neurological function. The pressure-responsive valve is configured to remain closed until the negative pressure within the patient's airway reaches about −7 cm H2O, at which time the pressure-responsive valve is configured to open to provide respiratory gases to flow to the lungs through the pressure-responsive valve. ## Claims ### Claim 1 A system for treating a patient in cardiac arrest comprising: a guidance device configured to provide feedback to a user to compress a patient's chest at a rate of between about 90 and 110 compressions per minute and at a depth of between about 4.5 centimeters per compression to about 6 centimeters per compression; a pressure regulation system comprising a pressure-responsive valve that is adapted to be coupled to a patient's airway, wherein the pressure-responsive valve is configured to remain closed during successive chest compressions in order to permit removal of at least about 200 ml of air from the lungs, and wherein the pressure-responsive valve is configured to remain closed until the negative pressure within the patient's airway reaches about −7 cm H2O to −18 cm H2O, at which time the pressure-responsive valve is configured to open to provide respiratory gases to flow to the lungs through the pressure-responsive valve. ### Claim 2 (depends on 1) The system according to claim 1, wherein: the guidance device comprises a chest compression device that is configured to allow a user to compress the chest in a repeated manner. ### Claim 3 (depends on 2) The system according to claim 2, wherein: the chest compression device further comprises an adhesive pad that is coupleable to the patient's chest such that by pulling upward on the chest compression device, a user may actively decompress the patient's chest. ### Claim 4 (depends on 1) The system according to claim 1, wherein: the pressure responsive valve is configured so that when the pressure-responsive valve opens, it provides resistance to the incoming gas flow at a level of about 7 to about 18 cm H2O at a flow rate of 20 L/min. ### Claim 5 (depends on 1) The system according to claim 1, further comprising: a positive pressure ventilation device that is configured to supply respiratory gases to the lungs at a rate in the range of about 6 to about 14 breaths per minute with a tidal volume of at least about 600 ml. ### Claim 6 (depends on 1) The system according to claim 1, wherein: the guidance device comprises one or more of a load cell to measure force or an accelerometer to provide the feedback to the user in terms of a proper rate and depth of chest compressions. ### Claim 7 (depends on 1) The system according to claim 1, wherein: the feedback comprises one or more of an audible sound produced by a speaker of the guidance device or a visual indicator produced by a light or screen of the guidance device. ### Claim 8 (depends on 1) The system according to claim 1, wherein: there is a resistance of between about 7 cm H2O and 18 cm H2O on flowing respiratory gases when the pressure-responsive valve is open. ### Claim 9 (depends on 1) The system according to claim 1, wherein: the chest compression device further comprises a visual indicator configured to direct a user in compressing the patient's chest at the rate between 90 to 110 compressions per minute. ### Claim 10 (depends on 1) The system according to claim 1, wherein the removal of air from the lungs decreases intracranial pressure in the patient and improves survival with favorable neurological function. ### Claim 11 A method of treating a patient in cardiac arrest, the method comprising: providing a valve system comprising a pressure-responsive valve that is adapted to be coupled to a patient's airway, the valve system being configured to remain closed during successive chest compressions in order to permit removal of at least about 200 ml of air from the lungs, wherein the valve system is configured to remain closed until the negative pressure within the patient's airway reaches about −7 cm H2O to −18 cm H2O, at which time the valve system is configured to open to provide respiratory gases to flow to the lungs, and wherein the valve system is configured so that when the valve system opens, it provides resistance to the incoming gas flow at a level of about 7 to about 18 cm H2O at a flow rate of 20 L/min; providing instructions to reduce blood volume from the brain by compressing the chest at a rate between about 90 to about 110 per minute at a depth of about 4.5 to about 6 cm; providing a guidance device that is configured to provide user feedback as to whether the chest compressions are being performed at a rate between 90 to 110 compressions per minute and at a depth of 4.5 cm per compression to about 6 cm per compression; providing instructions to provide positive pressure ventilation at a rate of 6 to 14 breaths per minute with a tidal volume of about 400 ml to about 70 ml. ### Claim 12 (depends on 11) The method according to claim 11, wherein: the guidance device comprises one or more of a load cell to measure force or an accelerometer to provide the feedback to the user in terms of the proper rate and depth of chest compressions. ### Claim 13 (depends on 11) The method according to claim 11, wherein: the feedback comprises an audible sound produced by a speaker of the guidance device. ### Claim 14 (depends on 11) The method according to claim 11, wherein: the feedback comprises a visual indicator produced by a light or screen of the guidance device. ### Claim 15 (depends on 11) The method according to claim 11, wherein: the guidance device comprises a chest compression device configured to provide the feedback to the user in terms of a proper rate and depth of chest compressions, the chest compression device having an adhesive pad that is coupleable to the patient's chest; and the method further comprises providing instructions to actively decompress the patient's chest by pulling upward on the chest compression device in between at least some of the compressions. ### Claim 16 (depends on 15) The method according to claim 15, wherein: the chest compression device configured to provide the feedback to the user in terms of a proper rate and depth of chest compressions further comprises an indicator configured to provide the feedback to the user in terms of compressing the patient's chest at the rate between 90 to 110 compressions per minute. ### Claim 17 (depends on 11) The method according to claim 11, wherein the removal of air from the lungs decreases intracranial pressure in the patient and improves survival with favorable neurological function. ### Claim 18 A system for treating a patient in cardiac arrest comprising: a housing comprising at least one pressure-responsive valve therein, the pressure-responsive valve adapted to be coupled to a patient's airway, wherein the pressure-responsive valve is configured to remain closed during successive chest compressions, and wherein the pressure-responsive valve is configured to remain closed until the negative pressure within the patient's airway reaches about −7 cm H2O to −18 cm H2O, at which time the pressure-responsive valve is configured to open to provide respiratory gases to flow to the lungs through the pressure-responsive valve; and a manual chest compression device for delivering manual chest compressions to the patient, the manual chest compression device comprising a processor and memory having stored thereon programming instructions that, when executed by the processor, cause the device to provide feedback to a user to compress a patient's chest at a rate of between about 90 and 110 compressions per minute and at a depth of between about 4.5 cm per compression to about 6 cm per compression. ### Claim 19 (depends on 18) The system of claim 18, wherein the manual chest compression device is an active compression decompression device. ### Claim 20 (depends on 18) The system of claim 18, wherein the feedback comprises one or more of an audible sound produced by a speaker of the guidance device or a visual indicator produced by a light or screen of the guidance device. ### Claim 21 (depends on 18) The system of claim 18, wherein the manual chest compression device comprises a user interface configured to display a target chest compression rate and an actual chest compression rate. ### Claim 22 (depends on 18) The system of claim 18, wherein the manual chest compression device comprises a user interface comprising one or more inputs corresponding to patient size. ### Claim 23 (depends on 18) The system of claim 18, wherein the valve is configured to permit removal of air from the lungs, thereby decreasing intracranial pressure in the patient and improving survival with favorable neurological function.