# Head Up CPR System with Integrated and Optimized Mechanical Active Compression Decompression for Improving Survival after Cardiac Arrest

> **NIH NIH R43** · ADVANCEDCPR SOLUTIONS LLC · 2022 · $394,832

## Abstract

Abstract
The overall goal of this application is to improve neurologically-intact survival rates after sudden cardiac arrest
(SCA), the leading cause of death in adults in the US. Despite conventional (C) CPR, <10% of 300,000 pre-
hospital and <30% of 300,000 in-hospital SCA patients in the US each year survive with favorable neurological
function. We propose to develop and evaluate a novel comprehensive Head Up Position (HUP) cardiopulmonary
resuscitation (CPR) System designed primarily to allow Basic Life Services (BLS) providers (a fire crew without
paramedics) to rapidly deliver fully automated CPR, including for the first time, automated breath delivery and
automated and optimized full lift active compression decompression, to increase the likelihood of neurologically
intact survival after SCA and increase crew safety. The proposal focuses on further developing and delivering
an innovative all-in-one HUP resuscitation system (HRS) for BLS teams based on our most recent breakthroughs
in optimizing brain perfusion during SCA using controlled sequential elevation of the head and thorax combined
with Active Compression Decompression (ACD) CPR and an impedance threshold device (ITD). As
demonstrated in a well-accepted porcine SCA model, HUP CPR combined with full lift ACD CPR and an ITD
uniquely harnesses gravity to enhance drainage of venous blood from the head and neck, lower intracranial
pressure, and markedly increase systemic and cerebral blood flow and likelihood for neurologically-intact
survival. The overall objectives of this application are also supported by new clinical data from a HUP CPR
Registry demonstrating this neuroprotective approach provides a striking benefit when deployed rapidly by
Emergency Medical Services (EMS) first responders. Moreover, in resource-strapped EMS systems countrywide
there is a growing need to develop technology that minimizes the number of resources required to deliver high
quality CPR that is best for patient outcomes and safer for rescue personnel. We propose to achieve these
collective objectives by demonstrating that incorporation of 1) automated and integrated ACD CPR and 2)
automated breath delivery into an easy to deploy and fully automated HUP CPR system, is feasible and safe for
BLS providers, will reduce CPR personnel resource requirements, and most importantly, will optimize chances
for neurologically intact survival after SCA. As such, the Specific Aims are: 1) Determine the optimal waveform
during HUP with full ACD CPR to optimize brain and heart blood flow and compare the optimized waveform with
a LUCAS 3.1 waveform in a porcine survival study and 2) Design and prototype a functional HRS, an all-in-one
device with integrated, optimized, and automated full ACD CPR and automated breath delivery.

## Key facts

- **NIH application ID:** 10482631
- **Project number:** 1R43HL162179-01A1
- **Recipient organization:** ADVANCEDCPR SOLUTIONS LLC
- **Principal Investigator:** Keith Lurie
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $394,832
- **Award type:** 1
- **Project period:** 2022-09-12 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10482631

## Citation

> US National Institutes of Health, RePORTER application 10482631, Head Up CPR System with Integrated and Optimized Mechanical Active Compression Decompression for Improving Survival after Cardiac Arrest (1R43HL162179-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10482631. Licensed CC0.

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